RESUMO
OBJECTIVE To evaluate the clinical efficacy and safety of XELOX chemotherapy （oxaliplatin+capecitabine） combined with antiangiogenic agent （apatinib） and immunotherapy （camrelizumab） in patients with inoperable metastatic colorectal cancer （CRC）of microsatellite stable （MSS） type. METHODS Clinical medical records of 40 patients with inoperable metastatic CRC of MSS type treated in Lishui People’s Hospital from January 2020 to January 2021 were retrospectively collected. According to the treatment plan， the patients were divided into control group （20 cases） and observation group （20 cases）. Control group was given XELOX+apatinib regimen， while observation group was given XELOX+apatinib+camrelizumab regimen. Every 3 weeks was a treatment cycle， and the treatment lasted for 2 consecutive cycles. The objective response rate （ORR）， disease control rate （DCR）， progression-free survival （PFS）， overall survival （OS） and adverse events （AEs） were recorded for all patients. RESULTS The ORR and DCR of observation group were 65.0% and 85.0%， respectively； and the ORR and DCR of control group were 35.0% and 75.0%， respectively， with no statistical significance between 2 groups （P＞0.05）. The median PFS of observation group and control groups were 16.0 months and 8.0 months， respectively； and the median OS were 19.0 months and 12.5 months， respectively， with statistical significance between 2 groups （P＜0.05）. Each patient in both groups had at least one AEs， and the incidences of reactive skin capillary hyperplasia and hyperthyroidism in observation group （40.0%， 20.0%） were significantly higher than those in control group （both were 0） （P＜0.05）. The incidence of nausea and vomiting in control group （90%） was significantly higher than observation group （10%） （P＜0.05）. There were 14 cases （70.0%） of patients with grade 3 or above AEs in observation group， and only 5 cases （25.0%） in control group， with statistical significance between 2 groups （P＜0.05）. However， no severe AEs that could not be tolerated or fatal occurred in the two groups， which could be alleviated after drug withdrawal or treatment. CONCLUSIONS The efficacy of XELOX chemotherapy combined with apatinib and camrelizumab in inoperable metastatic CRC patients of MSS type is comparable to that of XELOX chemotherapy combined with apatinib， but it has certain advantages in ORR， PFS and OS， and controllable safety.
RESUMO
Objective:To investigate the efficacy of different doses of apatinib combined with chemotherapy in the treatment of advanced gastric cancer and its effect on prognosis.Methods:Sixty-nine patients with advanced gastric cancer who received treatment in Lishui City People's Hospital from January 2015 to February 2019 were retrospectively analyzed. All patients received apatinib combined with teggio chemotherapy. These patients were divided into groups A, B and C according to the different dosages of apatinib used: 250 mg/d ( n = 21, group A), 500 mg/d ( n = 23, group B) and 850 mg/d ( n = 23, group C). The control rate of gastric cancer, serum levels of carcinoembryonic antigen, carbohydrate antigen 19-9 (CA19-9), carbohydrate antigen 72-4 (CA72-4), toxic and side effects, and survival within 1 year after surgery were determined among the three groups. Results:By the end of follow-up, one patient from group A was lost, one patient from group B interrupted medication because of personal reasons, and two patients from group C withdrew from the treatment due to serious discomfort caused by drugs. After treatment, disease control rate in group C was significantly higher than that in group A [91.30% (21/23) vs. 60.00% (12/20), χ2 = 6.484, P < 0.05]. Serum levels of carcinoembryonic, CA19-9 and CA72-4 in group C were (27.51 ± 2.21) μg/L, (101.46 ± 8.02) g/L, (46.34 ± 6.15) U/mL, respectively, which were significantly lower than those in group B [(29.33 ± 2.17) μg/L, (106.67 ± 8.10) g/L, (50.67 ± 6.20) U/mL, t = 2.786, 2.168, 2.352, all P < 0.05]. Serum levels of carcinoembryonic, CA19-9 and CA72-4 in group B were significantly lower than those in group A [(31.63 ± 2.92) μg/L, (112.12 ± 8.38) g/L, (55.12 ± 6.48) U/mL, t = 2.915, 2.142, 2.274, all P < 0.05]. The incidences of hand foot syndrome and gastrointestinal discomfort in group C were (34.78% (8/23) and (39.13% (9/23), respectively, which were significantly higher than those in group A [15.00% (3/23) and 25.00% (5/20), χ2 = 5.734, 4.769, both P < 0.05]. After 1-year follow-up,1-year survival rate in group C was significantly higher than that in group A [39.13% (9/23) vs. 10.00% (2/20), log-Rank χ2 = 6.600, P < 0.05]. Conclusion:High-dose apatinib combined with chemotherapy in the treatment of advanced gastric cancer has a high disease control rate and a high 1-year survival rate, but it has serious adverse drug reactions.