Clinical Observation And Analysis Of Apatinib In The Treatment Of Recurrent Cervical Cancer

Objective:To explore the clinical application of apatinib in the treatment of recurrent cervical cancer,aiming to provide a new basis for clinical treatment of patients with recurrent cervical cancer.Methods:Retrospective analysis of 61 patients with cervical cancer who had local recurrence after radiochemotherapy after January 1,2017 to June 30,2019,a total of 26 patients with apatinib combined with chemotherapy,chemotherapy alone Group 35 cases.Patients in the chemotherapy alone group received intravenous chemotherapy with paclitaxel liposome(135 mg/m2)and cisplatin(75 mg/m2),and patients in the apatinib group received paclitaxel liposome(135 mg/m2)and cisplatin(75 mg/m2)combined with apatinib(250mg/QD),all 61 patients with recurrent disease were previously treated with standardized concurrent chemoradiotherapy.After regular follow-up,gynecological examination suspected local recurrence,followed by imaging examination and local pathology confirmed local recurrence.The radiotherapy regimen was endovascular treatment combined with extracorporeal radiation therapy.The chemotherapy regimen was docetaxel(75 mg/m2)and cisplatin(75 mg/m2)/nedaplatin(75 mg/m2).After the follow-up,the survival rate,local remission and toxic side effects of the two groups were analyzed.Results:(1)One month after the end of chemotherapy,the evaluation showed that:The CR,PR,SD and PD in the apatinib combined with chemotherapy group were 4(15.38%),16(61.54%),3(11.54%)and 3(11.54%),.The effective rate was 76.92%.The CR,PR,SD and PD in the chemotherapy group were 2(5.70%),14(40.00%),11(31.43%)and 8(22.86%).The effective rate was 45.71%,the CR rate and total effective rate of the apatinib combined with chemotherapy group were significantly higher than the chemotherapy alone group,and the total effective rate was statistically significant(P<0.05).(2)By the time of follow-up,the 1-year and 2-year survival rates of the patients in the apatinib-adjuvant group were 80.77%and 42.31%,respectively.The OS was 22 months,the median PFS was 6.0 months,and 11 patients were still alive.The 1-and 2-year survival rates of the chemotherapy-only group were 71.43%and 34.28%,.The follow-up period was 3-24 months,the median follow-up time was 13.5 months,the median OS was 20 months,the median PFS was 4.0 months,and 12 patients were still alive.Compared with the two groups,the apatinib combined with the chemotherapy group for 1 year and The 2-year survival rate was significantly higher than that of the chemotherapy alone group(P=0.2172,P=0.5642,P>0.05).(3)The toxic side effects of the apatinib group were mainly myelosuppression,hand-foot syndrome,gastrointestinal reaction,and high.Blood pressure,hair loss and proteinuria were the main causes,and no serious bleeding adverse events occurred.Among them,Ⅰ～Ⅱ degree was the main one,and a few were Ⅲ-Ⅳ degree,which were tolerable.The incidence of myelosuppression,hand-foot syndrome,gastrointestinal reactions,hypertension,alopecia,and proteinuria in the apatinib group were 76.92%,61.54%,61.54%,73.08%,69.23%,and 63.58%.The acute toxic and side effects in the chemotherapy-only group were mainly myelosuppression,gastrointestinal reactions,alopecia,vaginal inflammation and pelvic fluid.They were mainly Ⅰ～Ⅱ,and a few were Ⅲ degrees.The incidence of myelosuppression,gastrointestinal reactions,alopecia,vaginal inflammation and pelvic fluid in the chemotherapy alone group were 74.28%,60.00%,74.28%,42.86%,and 28.57%.Conclusion:Compared with chemotherapy alone,apatinib combined with chemotherapy for recurrent cervical cancer can significantly improve CR and total effective rate,significantly improve the overall survival rate of patients 1 to 2 years,with good short-term efficacy.The toxicities increased compared with the control group,but it was not statistically significant.Among them,the 1-2 grade group was able to be tolerated,which deserves further clinical research.