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目的:探讨阿帕替尼在晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)中的治疗效果。方法:选取2015年1月至2016年3月于各成员单位收治的72例晚期NSCLC患者纳入研究对象,给予患者口服阿帕替尼,500 mg/次,1次/d,治疗至肿瘤进展、患者死亡或者出现药物毒性不耐受为止。随访并观察患者客观缓解率(objective response rate,ORR)、疾病控制率(disease control rate,DCR)、无进展生存期(progression-free survival,PFS)和毒副反应发生情况。采用单因素分析比较不同临床特征与PFS的关系。结果:患者中位PFS为4.8个月(95%CI 4.7~5.0)。单因素分析显示不同性别、年龄、活动状态(performance status,PS)评分、组织学类型、驱动基因突变情况、有无转移灶、转移灶数量、转移部位、治疗史、治疗线数和病程的患者PFS差异均无统计学意义(P>0.05)。患者ORR为13.89%,DCR为83.33%。疗效瀑布图显示有54例患者病灶缩小,以肿瘤病灶直径减少30%作为治疗有效标准,则有10例患者表现为部分缓解(partial response,PR)。有60例(83.33%)患者发生各类不良事件,其中22例(30.55%)≥Ⅲ级。结论:阿帕替尼治疗晚期NSCLC疗效显著,安全性高,可在临床进行更加深入的研究和应用。
Objective: To investigate the therapeutic effect of apatinib in advanced non-small cell lung cancer (NSCLC). Methods: From January 2015 to March 2016, 72 patients with advanced NSCLC admitted to their respective member institutions were enrolled in this study. Patients were given oral apatinib 500 mg once daily for tumor progression, The patient dies or is intolerant to drug toxicity. The objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS) and the incidence of side effects were observed and followed up. Univariate analysis was used to compare the relationship between different clinical features and PFS. Results: The median PFS was 4.8 months (95% CI 4.7-5.0). Univariate analysis showed that patients with different gender, age, performance status (PS) score, histological type, driver gene mutation status, presence or absence of metastases, number of metastases, sites of metastases, treatment history, number of treatment lines, and duration of disease PFS differences were not statistically significant (P> 0.05). Patients ORR was 13.89%, DCR was 83.33%. The efficacy waterfall map showed that 54 patients had lessened lesions, with a 30% reduction in tumor lesion diameter as the effective standard of treatment. Ten patients showed partial response (PR). There were 60 cases (83.33%) of all kinds of adverse events, of which 22 cases (30.55%) ≥ Ⅲ grade. Conclusion: Apatinib is effective in treating advanced NSCLC and has high safety. It can be further studied and applied clinically.