伊立替康联合阿帕替尼治疗术后转移性胃癌患者临床疗效和安全性分析

摘要 目的：探讨伊立替康联合阿帕替尼治疗术后转移性胃癌患者临床疗效和安全性。方法：选取我院2017年5月-2018年10月期间收治的术后一线化疗失败转移性胃癌患者105例，根据随机数字表法分为研究组（53例）和对照组（52例），对照组患者给予伊立替康静脉滴注治疗，研究组在此基础上使用阿帕替尼进行联合治疗，4周为一个周期，连续治疗两个周期。比较两组患者疾病控制率、生存情况，并对治疗前后两组患者肿瘤标志物癌胚抗原（CEA）、糖类抗原125（CA125）和糖类抗原199（CA199）]水平、基质金属蛋白酶-9（MMP-9）和血管内皮生长因子（VEGF）水平进行比较，观察治疗过程中两组患者不良反应发生情况。结果：治疗后，研究组疾病控制率、中位生存时间和中位进展时间均优于对照组（P<0.05）。治疗后，两组肿瘤标志物、MMP-9和VEGF水平均降低，且研究组低于对照组（P<0.05）。研究组不良反应发生率低于对照组（P<0.05）。结论：伊立替康联合阿帕替尼治疗术后转移性胃癌患者临床疗效确切，可延长患者生存时间，延缓疾病进展，且安全性较好，其作用机制可能与降低肿瘤标志物及MMP-9、VEGF水平有关。

Efficacy and Safety of Irinotecan Combined with Apatinib in the Treatment of Postoperative First-line Chemotherapy Failed Metastatic Gastric Cancer

ABSTRACT Objective: Explore the clinical efficacy and safety of irinotecan combined with apatinib in the treatment of postoperative first-line chemotherapy failed metastatic gastric cancer. Methods: 105 patients with postoperative first-line chemotherapy failed metastatic gastric cancer admitted to our hospital from May 2017 to October 2018 were divided into study group (53 cases) and control group (52 cases) according to the random number table method. Control group was given intravenous drip treatment of irinotecan, and study group was given combination treatment with apatinib on this basis, 4 weeks as a cycle, two consecutive cycles. The disease control rate and survival situation of the two groups were compared, and the levels of tumor markerscarcino-embryonic antigen (CEA), saccharide antigen 125 (CA125), saccharide antigen 199 (CA199)], matrix metalloproteinase-9 (MMP-9) and vascular endothelial growth factor (VEGF) were compared before and after the treatment. The incidence of adverse reactions in two groups during treatment was observed. Results: After treatment, the disease control rate, median progression time and median survival time of the study group was higher than that of control group (P<0.05). After treatment, the level of tumor markers, MMP-9 and VEGF in the two groups decreased, and the study group was lower than the control group (P<0.05). The incidence of adverse reactions in the study group was lower than that in study group (P<0.05). Conclusion: Irinotecan combined with apatinib in the treatment of postoperative first-line chemotherapy failed metastatic gastric cancer has a significant clinical effect, can prolong the survival of patients, delay disease progression, with a high safety, the mechanism of action may be related to the decrease of tumor markers, MMP-9 and VEGF levels.