替吉奥联合阿帕替尼三线治疗晚期肠癌患者的临床观察

  目的  观察替吉奥联合阿帕替尼用于晚期肠癌三线治疗的疗效和安全性。  方法  回顾性分析2016年4月至2018年8月华中科技大学同济医学院附属同济医院收治的44例采用替吉奥联合阿帕替尼治疗的三线肠癌患者临床病例资料，并进行随访，记录药物使用的有效性及不良反应数据。  结果  全组44例患者中位无进展时间（median progression-free survival time，mPFS）为3.93（2.72~5.15）个月，中位生存时间（median overall survival time，mOS）为7.77（5.36~10.18）个月。左半结肠及直肠癌患者mPFS为4.94个月，右半结肠癌患者mPFS为3.89个月，两组比较差异有统计学意义（P=0.024）；左半结肠及直肠癌患者mOS为12.5个月，右半结肠癌患者mOS为7.40个月，两组比较差异无统计学意义（P=0.080）；性别、既往是否使用过贝伐单抗以及是否存在肝转移对于mPFS及mOS无显著影响；初始治疗时ECOG评分0~1分及2分的患者mPFS分别为4.48个月及1.10个月（P < 0.001），mOS分别为9.67个月及2.90个月，两组比较差异均有统计学意义（P < 0.001）。治疗相关性不良反应最普遍的为乏力（52.3%），其次为高血压（45%）、手足综合征（22.7%）、蛋白尿（15.9%）、白细胞下降（15.9%）、血小板下降（22.7%）、转氨酶升高（13.6%）、腹泻（15.9%）。  结论  替吉奥联合阿帕替尼用于肠癌的三线治疗具有较好的疗效，不良反应方面安全可耐受。 

Clinical analysis of third-line combination therapy with S-1 plus apatinib for advanced colorectal cancer

  Objective  To investigate the efficacy and toxicity of apatinib combined with S1 as a third-line therapy for advanced colorectal cancer.  Methods  Forty-four patients with adavanced colorectal cancer from Tongji Hospital Cancer Center were enrolled from April 2016 to August 2018. The median follow-up period was 8 months. Data related to efficacy and adverse effects were recorded.  Results  The median progression-free survival (PFS) time was 3.93 months (95%CI:2.72-5.15 months), and the median overall survival (OS) time was 7.77 months (95%CI:5.36-10.18 months). Patients with left hemicolon cancer and rectal cancer group had a longer PFS than patients with right hemicolon cancer group (4.94 months vs. 3.89 months, P=0.024); the OS for left hemicolon cancer and rectal cancer was 12.5 months, the OS for right hemicolon cancer was 7.4 months, P=0.080; gender, previous bevacizumab use and liver metastasis had no statistically significant effect on PFS and OS; the PFS was 4.48 months and 1.10 month, in the patients with ECOG 0-1 and ECOG 2; the OS was 9.67 months and 2.90 month, in these two groups respectively. The major adverse effects of the combination therapy were fatigue (52.3%), hypertension (45%), hand-foot syndrome (22.7%), leukopenia (15.9%), and neutropenia (15.9%), thrombocytopenia (22.7%), elevated transaminase levels (13.6%), diarrhea (15.9%).  Conclusions  The results suggest that the combination of apatinib and S-1 is safe and effective as a third-line treatment for advanced colorectal cancer.