Efficacy of different doses of apatinib combined with chemotherapy in the treatment of advanced gastric cancer and its effect on prognosis / 中国基层医药

ABSTRACT

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.