| Background and Objective: Lung cancer is a malignant tumor with the highest morbidity and mortality in China and the world.According to reports,there was 18.1 million new cancer cases and 9.6 million cancer deaths worldwide in 2018.Among them,new cases of lung cancer account for 11.6% of all new cancer cases,and deaths account for 18.4% of all cancer deaths.Non-small cell lung cancer(NSCLC)is the most common type of lung cancer,accounting for 80%-85% of lung cancer.Angiogenesis plays an important role in tumorigenesis,development,and metastasis and prognosis of tumors.At present,anti-angiogenic drugs have occupied an important position in the treatment of NSCLC.In recent years,there have been studies of efficacy and safety in patients with NSCLC in a new anti-angiogenic drugs,and improved quality of life and prolong survival time of patients.The purpose of this study was to collect data on the clinical efficacy and side effects of oral apatinib as a second-or further-line in patients with advanced NSCLC in the first hospital of Jilin University,including progression-free survival,objective response rate,disease control rate,common side effects,and grading of side effects.And look for the factors related to the patient's PFS.Methods: A total of 43 patients with advanced NSCLC who were hospitalized in the Cancer Center of the First Hospital of Jilin University from January 1,2017 to December 31,2018 were enrolled.Statistical analysis was performed using the SPSS19.0 system.The Kaplan-Meier method was used for survival analysis and the COX proportional hazard model was used for single factor analysis.The difference was statistically significant at p<0.05.Results: 1.The efficacy evaluation of 43 patients did not reach CR.Among them,5 patients(11.6 %)evaluated the efficacy of PR,26 patients(60.5 %)evaluated the efficacy of SD,and 12 patients evaluated PD.Among all patients,the objective response rate(ORR)is 11.6 % and the disease control rate(DCR)is 72.1 %.The median PFS was 3.7 months.2.The ORR and DCR of 30 patients with ECOG score of 0-1 were 16.7% and 83.3%,respectively,and the median PFS was 5.4 months(95%CI: 3.129-7.671).The ORR and DCR of 13 patients with ECOG score of 2 were 0 and 4.6%,respectively,and the median PFS was 2.7 months(95%CI: 2.098-3.302).The difference between the two groups was statistically significant(P = 0.012).Other factors,such as age,gender,smoking history,EGFR mutation status and number of apatinib treatment lines,were not statistically significant between the groups.3.During the treatment of apatinib,the main adverse reactions were hypertension,which was 48.8%(44.2% for grade 1-2,4.7% for grade 3-4)and 39.5 %for hand-foot syndrome,the incidence of diarrhea was 18.6%(16.3% for grade 1-2,2.3% for grade 3-4),the incidence of nausea and vomiting was 18.6%,the incidence of proteinuria was 9.3%,and the incidence of fatigue was 7%.The incidence of hematologic toxicity was 7%,and the incidence of hepatotoxicity was 7%(4.7% for grade 1-2 and 2.3% for grade 3-4).Adverse events mainly showed 1-2 grades,occasionally patients with rash,oral mucositis,rapid heart rate,nosebleeds and so on.Conclusions: 1.In all patients with advanced NSCLC treated with apatinib,the median PFS is 3.7 months,the objective response rate(ORR)is 11.6%,and the disease control rate(DCR)is 72.1%.2.ECOG score is the influencing factor of median PFS.For patients with ECOG score of 0-1,oral low-dose apatinib therapy can show better therapeutic effect.3.Apatinib is convenient,effective and safe in the treatment of advanced NSCLC patients,and the incidence of adverse reactions is low and controllable.. |
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