安羅替尼聯合AN方案一線治療晚期野生型肺腺癌的回顧性研究

【摘要】 目的：探討安羅替尼聯合AN方案一線治療晚期野生型肺腺癌的臨床效果。方法：將上饒市人民醫院腫瘤科2020年2月—2022年2月收治的68例晚期野生型肺腺癌患者的臨床資料進行回顧性分析，按治療方案分作AN化療組（n=35）、安羅替尼聯合組（n=33）。比較兩組近期療效、腫瘤標志物水平及預后。結果：兩組客觀緩解率（ORR）比較，差異無統計學意義（Pgt;0.05）；安羅替尼聯合組疾病控制率（DCR）為81.82%，高于AN化療組的54.29%，差異有統計學意義（Plt;0.05）。治療前，兩組癌胚抗原（CEA）、血管內皮生長因子（VEGF）及細胞角蛋白19片段（CYFRA21-1）比較，差異均無統計學意義（Pgt;0.05）；治療后，兩組CEA、VEGF、CYFRA21-1較治療前均降低，且安羅替尼聯合組均低于AN化療組（Plt;0.05）。安羅替尼聯合組Ⅰ+Ⅱ級疲乏發生率高于AN化療組（Plt;0.05）；兩組Ⅲ+Ⅳ級疲乏，Ⅰ+Ⅱ級與Ⅲ+Ⅳ級咯血、骨髓抑制、肝腎毒性、胃腸道反應及手足綜合征比較，差異均無統計學意義（Pgt;0.05）。經log-rank檢驗，安羅替尼聯合組無進展生存期（PFS）、總生存期（OS）均長于AN化療組（Plt;0.05）。結論：應用安羅替尼聯合AN方案一線治療晚期野生型肺腺癌具有一定療效，腫瘤標志物水平獲得改善，預后較好，且毒副反應在可控范圍內。

【關鍵詞】 野生型肺腺癌 一線治療 安羅替尼 回顧性研究

A Retrospective Study on the First-line Treatment of Advanced Wild-type Lung Adenocarcinoma with Arotinib Combined with AN Regimen/LIN Zheng， ZHOU Jin， HUANG Kairong. //Medical Innovation of China， 2023， 20（31）： 0-037

[Abstract] Objective： To investigate the clinical effect of Anrotinib combined with AN regimen in the first-line treatment of advanced wild-type lung adenocarcinoma. Method： Clinical data of 68 patients with advanced wild-type lung adenocarcinoma admitted to Shangrao People's Hospital Department of Oncology from February 2020 to February 2022 were retrospectively analyzed， and divided into AN chemotherapy group （n=35） and Anrotinib combined group （n=33） according to treatment plan. The short-term efficacy， tumor marker level and prognosis of the two groups were compared. Result： There was no statistical significance in objective response rate （ORR） between the two groups （Pgt;0.05）; the disease control rate （DCR） in the Antirotinib combined group was 81.82%， which was higher than 54.29% in the AN chemotherapy group， the difference was statistically significant （Plt;0.05）. There were no significant differences in carcino-embryonic antigen （CEA）， vascular endothelial growth factor （VEGF） and cytokeratin 19 fragment （CYFRA21-1） between the two groups before treatment （Pgt;0.05）; after treatment， CEA， VEGF and CYFRA21-1 were decreased of the two groups compared with before treatment， and the Anrotinib combined group were lower than those in the AN chemotherapy group （Plt;0.05）. The incidence of grade Ⅰ+Ⅱ fatigue in Anrotinib combined group was higher than that in AN chemotherapy group （Plt;0.05）; there were no significant differences in grade Ⅲ+Ⅳ fatigue， grade Ⅰ+Ⅱ and grade Ⅲ+Ⅳ hemoptysis， myelosuppression， hepatorenal toxicity， gastrointestinal reaction and hand-foot syndrome between the two groups （Pgt;0.05）. log-rank test showed that progression-free survival （PFS） and overall survival （OS） in the Anrotinib combined group were longer than those in the AN chemotherapy group （Plt;0.05）. Conclusion： The first-line treatment of advanced wild-type lung adenocarcinoma with Anrotinib combined with AN regimen has certain efficacy， the level of tumor markers is improved， the prognosis is good， and the toxic and side effects are controllable.

[Key words] Wild-type lung adenocarcinoma First-line treatment Anrotinib Retrospective study

First-author's address： Shangrao People's Hospital， Jiangxi Province， Shangrao 334000， China

doi：10.3969/j.issn.1674-4985.2023.31.008

肺癌系臨床常見呼吸道惡性腫瘤。由全球癌癥統計報道顯示：肺癌發病率（11.6%）及死亡率（18.4%）均處首位[1]。其中，非小細胞癌占比達85%，亞型中肺腺癌占比30%～35%，且于近些年呈上升趨勢。因肺腺癌早期無典型癥狀，難以于早期及時發現，患者首診時多發展為晚期，喪失根治性手術治療機會。對此，行鉑類聯合其他藥物化療為治療基石。……