阿帕替尼联合多西他赛与多西他赛二线治疗晚期非鳞非小细胞肺癌的疗效、安全性及预后对比

目的:对比阿帕替尼联合多西他赛与单纯多西他赛在晚期非鳞非小细胞肺癌(NSCLC)二线治疗中的疗效及安全性，并对预后影响因素进行分析。方法:纳入98例晚期非鳞NSCLC，随机分为治疗组（阿帕替尼联合多西他赛）48例以及对照组（多西他赛）50例，观察客观缓解率（ORR)、疾病控制率（DCR)、无进展生存期（PFS)、总生存期（OS）及不良反应，并将治疗组的临床病理因素纳入单因素及多因素分析。结果:两组患者近期疗效无明显差异；中位PFS分别为4.1个月与3.1个月（P=0.045）；中位OS分别为10.4个月与8.8个月（P=0.023）。两组患者3-4级不良反应发生例数未见明显差异。单因素分析显示中高分化、转移灶≤1个预后较好，多因素分析提示肿瘤分化程度是阿帕替尼联合多西他赛治疗晚期非鳞NSCLC的独立预后因素。结论:在晚期非鳞NSCLC二线治疗中，阿帕替尼联合多西他赛与多西他赛对比有生存获益，且耐受性好，肿瘤分化程度是独立的预后因素。

Efficacy,safety and prognosis of apatinib plus docetaxel compared with docetaxel in the second line treatment in advanced non-squamous non-small cell lung cancer

Objective:To compare the efficacy and safety of apatinib plus docetaxel and docetaxel in advanced non-squamous non-small cell lung cancer(NSCLC)who progressed after first-line chemotherapy and analyze prognostic factors.Methods:98 advanced non-squamous NSCLC patients were included in this study and randomly divided into two groups,48 in apatinib plus docetaxel group,50 in docetaxel group,ORR,DCR,PFS,OS and adverse events were observed.Clinical and pathological variables were included in univariate and multivariate analysis.Results:Median progression-free survival(PFS)in two groups were 4.1 months and 3.1 months each(P=0.045).Median overall survival(OS)were 10.4 months and 8.8 months each(P=0.023).There was no significant difference in grade 3 or 4 adverse events between groups.Univariate analysis showed that patients with moderate to well differentiation and metastasis number≤1 were correlated with better prognosis.Multivariate analysis showed that tumor differentiation was the independent prognostic factor for PFS and OS.Conclusion:Significant survival benefit could be seen in apatinib plus docetaxel group compared with docetaxel group among advanced non-squamous NSCLC patients in the second line treatment.Tumor differentiation was the independent prognostic factor for PFS and OS.