Efficacy of intensive radiotherapy combined with mesylate apatinib for treatment of elderly patients with locally advanced cardia cancer and its effect on vascular endothelial growth factor receptor / 肿瘤研究与临床

ABSTRACT

Objective To observe the clinical effect of intensity modulated radiation therapy (IMRT) combined with apapatinib mesylate in the treatment of elderly patients with locally advanced cardia adenocarcinoma and its effect on vascular endothelial growth factor receptor (VEGFR). Methods Forty-six elderly patients with locally advanced cardia cancer who were unwilling to accept surgery or couldn't get complete removal of cancers in Xuzhou Hospital Affiliated to Jiangsu University between January 2015 and April 2016 were collected. All the patients were randomly divided into the control group (23 cases) and the observation group (23 cases) according to the random number table method. The control group received radiotherapy alone. In the observation group, oral apatinib (500 mg/d) was taken in the first day of radiotherapy after breakfast until the disease progress or death occurred. Results The total effective rate was 92 % (19/23) in the observation group and 60 % (10/23) in the control group. There was a significant difference between the two groups(χ2=5.86,P <0.05). After treatment, the average level of VEGFR in both groups was decreased[(76.3±4.9)vs.(55.0±2.3)pg/ml],and there was a significant difference between the two groups (t = 3.93, P < 0.05). The common adverse reactions were blood adverse reactions and gastrointestinal reactions. The incidence rate of gastrointestinal reaction was both 83 %, and the blood adverse reaction was 100 %, and there was no significant difference between the two groups (both P > 0.05). Hypertension, proteinuria and rash response in the observation group were increased compared with the control group,but noⅣ grade of adverse reactions occurred. The median progression-free survival time was 10 months in the observation group and 8 months in the control group respectively (P = 0.01). Conclusion IMRT combined with apatinib in the treatment of elderly patients with locally advanced gastric cardia has a favorable efficacy and tolerance.