Effects of apatinib in the treatment of advanced hepatocellular carcinoma associated with hepatitis B / 国际肿瘤学杂志

ABSTRACT

Objective To observe the effects of apatinib in the treatment of advanced hepatocellular carcinoma associated with hepatitis B. Methods The clinical data of 72 patients with advanced hepatocellular carcinoma associated with hepatitis B admitted to the First Affiliated Hospital of Bengbu Medical College from January 2015 to May 2017 were retrospectively analyzed. Among them,37 patients were treated with apatinib once a day,as apatinib group;35 patients were treated with FOLFOX4(oxaliplatin + calcium folinate + 5-fluorouracil)palliative chemotherapy,as FOLFOX4 group. The objective response rate(ORR),disease con-trol rate(DCR),serum alpha fetal protein(AFP),improvement of clinical symptoms,Karnofsky functional status(KPS)score improvement rate,median progression-free survival(PFS),median overall survival(OS), and the incidence of adverse reactions from both groups were contrastively analyzed. Results The ORR of apa-tinib group(27. 03％ ,10 / 37)was higher than that of FOLFOX4 group(17. 14％ ,6 / 35),and DCR (64. 86％ ,24 / 37)was also higher than that of FOLFOX4 group(48. 57％ ,17 / 35). However,there were no significant difference in ORR and DCR between the two groups(χ2 = 1. 017,P = 0. 313;χ2 = 1. 948,P =0. 163). After 16 weeks of treatment,serum AFP of apatinib group[(280 ± 20)ng/ ml]was significantly lower than that in FOLFOX4 group[(450 ± 20)ng/ ml,t = 36. 049,P < 0. 001]. Improvement rate of KPS score(86. 49％ ,32 / 37)was significantly more than that of FOLFOX4 group(57. 14％ ,20 / 35;χ2 = 7. 720, P = 0. 006). Improvement rate of clinical symptoms(72. 97％ ,27 / 37)was significantly more than that of FOLFOX4 group(42. 86％ ,15 / 35;χ2 = 6. 712,P = 0. 010). The mean PFS of apatinib group was 6. 2 months,which was significantly longer than that of FOLFOX4 group(2. 8 months,χ2 = 4. 815,P = 0. 028). The mean OS of apatinib group was 10. 9 months,which was significantly longer than that of FOLFOX4 group (6. 6 months,χ2 = 26. 429,P < 0. 001). In apatinib group,the main adverse reactions were hypertension, proteinuria and hand-foot syndrome;and in FOLFOX4 group,the main adverse reactions were leukopenia,neu-rotoxicity and liver function damage. Moreover,the adverse reactions in both groups were mostly 1 or 2 grade, which could be relieved or improved through symptomatic treatment. Conclusion Apatinib is safe and effective in the treatment of advanced hepatocellular carcinoma associated with hepatitis B. It can significantly prolong the life of patients and improve the quality of life and the clinical symptoms of patients.