阿帕替尼联合SOX方案对晚期胃癌患者疗效的影响

Effect of Apatinib Combined with SOX Regimen on the Efficacy of Patients with Advanced Gastric Cancer

关键词:  阿帕替尼  替吉奥联合奥沙利铂方案  晚期胃癌  血常规  低氧诱导因子  血管内皮生长因子

Key words:  apatinib  SOX regimen  advanced gastric cancer  blood routine  hypoxia inducible factor  vascular endothelial growth factor

摘要:

目的 探究阿帕替尼联合替吉奥联合奥沙利铂(SOX)方案对晚期胃癌患者疗效、血常规、血清低氧诱导因子1α(hypoxia inducible factor 1α，HIF-1α)及血管内皮生长因子(vascular endothelial growth factor，VEGF)水平的影响。方法 前瞻性选取2018年1月—2019年1月在内蒙古包钢医院接受诊治的96例晚期胃癌患者作为研究对象，采用随机数字表法简单随机分为2组，对照组(48例)予SOX方案治疗，观察组(48例)在对照组的基础上予阿帕替尼治疗，21 d为1个周期，均治疗2个周期。比较2组患者疗效，治疗前后血常规、血清HIF-1α和VEGF水平以及治疗期间不良反应发生情况。结果 观察组无疾病进展生存时间和总生存时间的平均值以及中位数均高于对照组(P<0.05)。重复测量方差分析显示时点效应、治疗方式、时点和治疗方式的交互效应均可以显著改变白细胞、血红蛋白、血小板、HIF-1α、VEGF水平(P<0.05)；且观察组治疗后白细胞、血红蛋白、血小板、HIF-1α和VEGF水平降低程度较对照组明显(P<0.05)。观察组药物治疗期间Ⅰ~Ⅳ度和Ⅲ~Ⅳ度高血压、口腔溃疡、乏力、手足皮肤反应、神经毒性、白细胞减少和血小板减少的发生率与对照组比较，差异无统计学意义。结论 阿帕替尼联合SOX化疗方案可显著延长晚期胃癌患者生存期，降低血清HIF-1α及VEGF水平，安全性较高，但会对血小板、白细胞和血红蛋白等血常规指标造成一定的影响。

Abstract:

OBJECTIVE To investigate the effects of apatinib combined with SOX regimen on the efficacy, blood routine, serum hypoxia inducible factor 1α(HIF-1α) and vascular endothelial growth factor(VEGF) levels in patients with advanced gastric cancer. METHODS Prospectively selected 96 patients with advanced gastric cancer who were diagnosed and treated in Inner Mongolia Baogang Hospital, from January 2018 to January 2019 as the research objects, and they were simply randomly divided into two groups using a random number table method. The control group(48 cases) was treated with SOX regimen. The observation group(48 cases) was treated with apatinib on the basis of the control group. The 21 d was 1 cycle, and both were treated for 2 cycles. The efficacy, blood routine, serum HIF-1α and VEGF levels before and after treatment, and the occurrence of adverse reactions during treatment of the two groups were compared. RESULTS The average and median of disease progression-free survival time and overall survival time of the observation group were higher than those of the control group(P<0.05). Repeated measurement analysis of variance showed that the time point effect, treatment method, time point and treatment method interaction effects could all significantly change the levels of white blood cells, hemoglobin, platelets, HIF-1α, and VEGF(P<0.05); and the levels of white blood cells, hemoglobin, platelets, HIF-1α and VEGF after treatment in observation group were significantly lower than those in the control group(P<0.05). The observation group had no statistically significant differences in the incidence of Ⅰ-Ⅳ and Ⅲ-Ⅳ hypertension, oral ulcers, fatigue, hand-foot skin reactions, neurotoxicity, leukopenia, and thrombocytopenia during drugs treatment in the observation group. CONCLUSION Apatinib combined with SOX chemotherapy regimen for advanced gastric cancer can significantly prolong survival and reduce serum HIF-1α and VEGF levels with a higher safety profile, but it has a certain impact on platelets, white blood cells, hemoglobin and other routine blood indicators.