文章摘要

阿帕替尼联合替吉奥二线治疗III~IV期胃癌近期疗效及对血清CEA和CA19-9水平的影响

作者: 1蔡清, 1徐金发, 1章秀芳, 1张建华, 1潘明
1 池州市人民医院肿瘤科,安徽 池州 247000
通讯: 蔡清 Email: 815258754@qq.com
DOI: 10.3978/j.issn.2095-6959.2020.08.005

摘要

目的:探讨阿帕替尼联合替吉奥二线治疗III~IV期胃癌的近期疗效及对血清癌胚抗原(carcino-embryonic antigen,CEA)、糖蛋白抗原(carbohydrate antigen 19-9,CA19-9)水平的影响。方法:选取池州市人民医院肿瘤内科2015年3月1日至2018年12月31日期间诊治的80例经一线治疗失败的III~IV期胃癌患者,采用随机数表法分为单药组和联合组,每组各40例。III~IV期胃癌患者在常规治疗基础上,单药组给予替吉奥治疗,联合组给予阿帕替尼联合替吉奥治疗,每周期3周,持续治疗2~3个化学药物治疗(以下简称化疗)周期。采用实体瘤评价标准(Response Evaluation Criteria in Solid Tumors,RECIST)比较两组肿瘤缓解有效率(response rate,RR)、肿瘤控制率(disease control rate,DCR),检测治疗前血清肿瘤标志物CEA和CA19-9水平,并采用世界卫生组织抗癌药物毒性表现标准(0~IV度)评估两组治疗期间不良反应情况。结果:联合组RR和DCR分别为32.50%和77.50%,单药组RR和DCR分别为22.50%和55.00%,联合组DCR明显高于单药组,差异有统计学意义(χ2=4.528,P<0.05);单药组治疗前后血清CEA和CA19-9水平无明显变化(P>0.05),联合组治疗后血清CEA和CA19-9水平明显下降(P<0.05),也显著低于单药组,差异有统计学意义(P<0.05);两组不良反应以I~II度为主,组间恶心、呕吐、腹泻、腹痛、乏力、白细胞减少、血小板减少、肝酶异常、电解质异常、皮疹和手足综合征发生率差异均无统计学意义(均P>0.05),联合组上消化道出血和口腔黏膜炎发生率高于单药组,差异有统计学意义(均P<0.05)。结论:阿帕替尼联合替吉奥二线治疗III~IV期胃癌可有效控制病情进展,降低血清CEA和CA19-9水平,且不良反应以I~II度为主,患者耐受性好,临床应用价值显著。
关键词: III~IV期胃癌;阿帕替尼;替吉奥;近期疗效;血清癌胚抗原;糖蛋白抗原水平;不良反应

Short-term efficacy of apatinib combined with tegio in the treatment of stage III–IV gastric cancer and its effect on serum CEA and CA19-9 levels

Authors: 1CAI Qing, 1XU Jinfa, 1ZHANG Xiufang, 1ZHANG Jianhua, 1PAN Ming
1 Department of Oncology, Chizhou People’s Hospital, Chizhou Anhui 247000, China

CorrespondingAuthor: CAI Qing Email: 815258754@qq.com

DOI: 10.3978/j.issn.2095-6959.2020.08.005

Abstract

Objective: To investigate the short-term efficacy of apatinib combined with tegio in the treatment of stage III–IV gastric cancer and the effect on the levels of carcino embryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9). Methods: Eighty patients with stage III–IV gastric cancer who failed in the first-line treatment during from March 1, 2015 to December 31, 2018 in the Department of Oncology of Chizhou People’s Hospital were randomly divided into single drug group and combined group with 40 cases in each group. On the basis of routine treatment, all patients with stage III–IV gastric cancer were treated with tegio alone in the single drug group and apatinib combined with tegio in the combined group, all of which lasted for 3 weeks/chemotherapy cycle and 2–3 chemotherapy cycles.Response evaluation criteria in solid tumors (RECIST) was used to compare the response rate (RR) and the disease control rate (DCR) of the two groups. CEA and CA19-9 levels of serum tumor markers before treatment were measured. The World Health Organization criteria for the toxicity of anticancer drugs (0–IV degree) was used to evaluate them To evaluate the side effects of the two groups during the treatment. Results: The RR and DCR of the combination group were 32.50% and 77.50%, respectively, and the RR and DCR of the single drug group were 22.50% and 55.00%, respectively. The DCR of the combination group was significantly higher than that of the single drug group, the difference was statistically significant (P<0.05). There was no significant change in serum CEA and CA19-9 levels before and after treatment in the single drug group (P>0.05), but the serum CEA and CA19-9 levels in the combined group decreased significantly (P<0.05), which was also significantly lower than that in the single drug group, the difference was statistically significant (P<0.05); there was no significant difference in the incidence of nausea and vomiting, diarrhea and abdominal pain, asthenia, leukopenia, thrombocytopenia, liver enzyme abnormality, electrolyte abnormality, rash and HFS between the two groups (all P>0.05), the incidence of upper gastrointestinal hemorrhage and oral mucositis in the combined group was higher than that in the single drug group (all P<0.05). Conclusion: apatinib combined with second-line treatment of tegio can effectively control the progression of gastric cancer, reduce the level of serum CEA and CA19-9, and the side effects are mainly I–II degree. The patients have good tolerance and significant clinical application value.
Keywords: stage III–IV gastric cancer; apatinib; tegio; short-term efficacy; serum carcinoembryonic antigen; carbohydrate antigen 19-9 level; side effects