| Objective:Through retrospective analysis,this study summarized and analyzed the relationship between the short-term clinical efficacy and progression-free survival of apatinib in the treatment of advanced breast cancer with the baseline characteristics of patients and the treatment-related side effects with a total incidence of?20%.In order to find a better maintenance treatment for advanced breast cancer,and hope to find indicators to predict the efficacy of apatinib,and to provide a theoretical basis for follow-up research and clinical medication.Methods:The clinical data of 48 patients with advanced breast cancer who were treated in the affiliated Hospital of Inner Mongolia Medical University from 2017-01 to 2019-12 were retrospectively analyzed.The clinical data of 48 patients with advanced breast cancer who had failed or relapsed or metastasized by the second-line or above standard treatment and who were advised to use apatinib by doctors were retrospectively analyzed.All the patients were female with an average age of 51.79±8.21 years old.SPSS 20.0 software was used for data statistics.X~2test was used to explore the relationship between the short-term efficacy(ORR,DCR)of apatinib and the baseline characteristics of patients,such as age,blood pressure status,ECOG score,immunohistochemical type,pathological type,metastasis,chemotherapy line and transaminase level.Kaplan-Meier test was used for survival analysis.COX regression analysis was used to explore the factors affecting survival in all baseline characteristics and treatment-related adverse reactions with an incidence of?20%.In the statistical analysis,the bilateral test was taken,and the significance test level was?=0.05.Results:Among the 48 patients who could evaluate the curative effect,no one got CR,and got PR in 8 cases,SD in 29 cases,and PD in 11 cases(including those who progressed before the second evaluation),ORR 16.67%,DCR 77.08%.In grouping analysis,the short-term curative effect of ECOG 0-1 group was better than that of 2-3 group(X~2=4.68,P=0.026).26 patients with visceral metastasis had m PFS 4.8 months(1.5-7.2 months),22 cases of non-visceral metastasis(including lymph node metastasis,pleural invasion,accessory breast metastasis,etc),had m PFS 5.7 months(2.5-8.3 months),the survival curve of patients with visceral metastasis was significantly different from that of patients with visceral metastasis.There were 21 cases with Ki-67?14%,m PFS 6.1 months(4.2-8.3 months),27 cases with Ki-67>14%,and m PFS 3.9 months(1.5-7.2 months).There was significant difference in survival curve between the two groups(X~2=7.741,P=0.005).15 patients with normal transaminase at the beginning of treatment,m PFS 7.0 months(3.0-8.3 months),33 cases with elevated transaminase,m PFS 4.2 months(1.5-7.3 months),there was significant difference in survival curve between the two groups(X~2=9.662,P=0.002).A total of 40 cases of drug-related adverse events occurred in 48 patients,of which 18 cases had 2 or more adverse events.All the adverse events were grade 1-3,and no grade 4 adverse events related to drugs occurred.Ki-67>14%is an independent risk factor for PFS in patients with advanced breast cancer,and secondary hypertension is an independent protective factor for PFS in patients with advanced breast cancer.Conclusions:(1)Apatinib has certain clinical efficacy and survival benefit in the maintenance treatment of advanced breast cancer,and the adverse reactions are controllable and well tolerated;(2)Clinical stage and ECOG score will affect the short-term curative effect of the patients,while visceral metastasis and Ki-67 index will affect the long-term curative effect of the patients;(3)The increase of transaminase before treatment can shorten the progression-free survival time of patients;(4)Hypertension related to apatinib treatment is a protective independent factor affecting the prognosis of patients,and Ki-67>14%is an independent risk factor affecting prognosis,which may be used as an index to predict the efficacy of apatinib. |
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