Prognostic analysis of irinotecan combined with apatinib in treatment of advanced gastric cancer / 肿瘤研究与临床

ABSTRACT

Objective:To explore the effect of irinotecan combined with apatinib on the prognosis of patients with advanced gastric cancer.Methods:Sixty-two patients with advanced gastric cancer who were admitted to Shanghai Minhang District Cancer Hospital from January 2016 to October 2018 were selected. Among them, 30 patients were treated with apatinib (control group), and 32 cases were treated with irinotecan combined with apatinib(observation group). Before administration, the two groups were given routine symptomatic intervention, including prevention of vomiting, improvement of leukocyte, nutrition supplement, etc. During the treatment, routine blood examination, liver and kidney function examination were carried out regularly, and the drug dosage was adjusted according to the situation. The chemotherapy regimen was given once every 3 weeks, and both groups received 4 cycles of treatment. After 3 months of treatment, the short-term efficacy was evaluated, and the therapeutic effects of the two groups were compared. The incidence of side effects was analyzed. After 12 months of follow-up, the survival curves were drawn by Kaplan-Meier method, and the progression-free survival (PFS) and overall survival (OS) of the two groups were analyzed.Results:The recent overall remission rates of the observation group and the control group were 9.38% (3/32) and 3.33% (1/30), and the difference was not statistically significant ( χ2 = 0.203, P = 0.652). The disease progression rate of the observation group was lower than that of the control group, and the difference was statistically significant [28.13% (9/32) vs. 53.33% (16/30), χ2 = 4.089, P = 0.043]. There was no statistical difference in the incidence of platelet decline, hemoglobin decline, white blood cell decline, diarrhea, nausea and vomiting, liver damage, and bone marrow suppression between the two groups (both P > 0.05). The median PFS and OS time in the observation group were 5.8 months (5.0-6.3 months) and 8.1 months (7.2-9.3 months), respectively, which were longer than those in the control group [4.9 months (4.7-5.1 months) and 6.0 months (5.2-6.9 months), and the differences were statistically significant (both P < 0.01). Conclusion:The combination of irinotecan and apatinib can reduce the disease progression rate, prolong the survival time, and does not increase the adverse reactions.