2019 年第 8 期 第 14 卷

安罗替尼与贝伐珠单抗分别联合紫杉醇加卡铂治疗晚期肺腺癌的临床效果

Comparison of anlotinib versus bevacizumab combined with paclitaxel and carboplatin in treatment of advanced lung adenocarcinoma

作者：孟令新曾琴琴孟芹郑玉秀徐美玲厉兵城吴海英周丹丹

英文作者：

单位：276826山东省日照市人民医院肿瘤科

英文单位：

关键词：肺腺癌；安罗替尼；贝伐珠单抗；紫杉醇；抗血管生成

英文关键词：

• 摘要：

• 【摘要】目的    探讨安罗替尼与贝伐珠单抗分别联合紫杉醇加卡铂治疗晚期肺腺癌的近期疗效和安全性。方法    回顾性分析2017年6月至2018年6月山东省日照市人民医院肿瘤科收治的经病理学确诊的晚期肺腺癌（ⅢB期或Ⅳ期）136例患者的临床资料，根据治疗方法将136例患者分为化疗组（64例）、安罗替尼组（34例）和贝伐珠单抗组（38例）。化疗组给予单纯化疗治疗；安罗替尼组在单纯化疗基础上给予盐酸安罗替尼胶囊治疗；贝伐珠单抗组在单纯化疗基础上给予贝伐珠单抗治疗。比较3组患者近期疗效、治疗过程中不良反应发生率和治疗前后肿瘤标志物［血管内皮生长因子（VEGF）、癌胚抗原和神经元特异性烯醇化酶（NSE）］水平。结果    安罗替尼组、贝伐珠单抗组的客观缓解率和疾病控制率均明显高于化疗组［67.6%(23/34)、50.0%(19/38)比20.3%(13/64)；79.4%(27/34)、65.8%(25/38)比39.1%(25/64)］，差异均有统计学意义（均P＜0.05）。安罗替尼组客观缓解率及疾病控制率均高于贝伐珠单抗组，差异均有统计学意义（P=0.022、0.016）。3组患者临床常见不良反应发生率比较，差异均无统计学意义（均P＞0.05)。治疗前，3组患者VEGF、癌胚抗原和NSE水平比较，差异均无统计学意义（均P＞0.05）。治疗后各组肿瘤标志物水平均明显低于治疗前，且安罗替尼组和贝伐珠单抗组VEGF、癌胚抗原、NSE水平均低于化疗组［（303±64）、（336±71）ng/L比（416±69）ng/L；（6±4）、（8±4）μg/L比（12±4）μg/L；（14.4±4.6）、（16.2±3.7）μg/L比（20.3±2.7）μg/L］，差异均有统计学意义（均P＜0.05）。结论    安罗替尼和贝伐珠单抗分别联合紫杉醇加卡铂用于晚期肺腺癌临床疗效确切，可提高客观缓解率和疾病控制率，降低VEGF、癌胚抗原、NSE水平，安全性较高，耐受性较好。

• 【Abstract】Objective    To investigate the short-term efficacy and safety of anlotinib and bevacizumab combined with paclitaxel and carboplatin in the treatment of advanced lung adenocarcinoma. Methods    A retrospective analysis was performed on 136 patients with advanced lung adenocarcinoma(stage ⅢB or Ⅳ) admitted to People′s Hospital of Rizhao from June 2017 to June 2018. Among them, 64 patients were treated with paclitaxel/carboplatin chemotherapy（chemotherapy group）; 34 patients were treated with anlotinib+paclitaxel/carboplatin chemotherapy(anlotinib group); 38 patients were treated with bevacizumab+paclitaxel/carboplatin chemotherapy(bevacizumab group). Short-term efficacy, adverse reactions and levels of tumor markers［vascular endothelial growth factor（VEGF）, carcinoembryonic antigen(CEA) and neuron-specific enolase（NSE）］ were analyzed. Results    Objective remission rate and disease control rate in anlotinib group and bevacizumab group were significantly higher than those in chemotherapy group［67.6%(23/34), 50.0%(19/38)vs 20.3%(13/64); 79.4%(27/34), 65.8%(25/38)vs 39.1%(25/64)］（all P＜0.05）. Objective remission rate and disease control rate in anlotinib group were significantly higher than those in bevacizumab group(P=0.022, 0.016). There was no significant difference in the incidence of common adverse reactions among the three groups(all P＞0.05). Before treatment, there was no significant difference in the levels of VEGF, CEA and NSE among the three groups(all P＞0.05). After treatment, the levels of tumor markers significantly decreased and they were significantly lower in anlotinib group and bevacizumab group than those in chemotherapy group［（303±64）,（336±71）ng/L vs （416±69）ng/L; （6±4）,（8±4）μg/L vs （12±4）μg/L; （14.4±4.6）,（16.2±3.7）μg/L vs （20.3±2.7）μg/L］（all P＜0.05）. Conclusions    Anlotinib and bevacizumab combined with paclitaxel/carboplatin chemotherapy show definite efficacy in the treatment of advanced lung adenocarcinoma. Both regimens are effective, safe and well tolerated in improving objective remission rate and disease control rate, reduce the levels of VEGF, CEA and NSE.