2023 年第 12 期 第 18 卷

阿帕替尼联合依托泊苷应用于广泛期小细胞肺癌维持治疗的效果及对血管内皮生长因子和其受体2水平的影响

The effect of apatinib combined with etoposide in maintenance therapy of extensive small cell lung cancer and its impact on levels of vascular endothelial growth factor and its receptor 2

作者：张海利董桂兰王志武刘丽丽吕立丽

英文作者：Zhang Haili Dong Guilan Wang Zhiwu Liu Lili Lyu Lili

单位：河北省唐山市人民医院放化疗五科，唐山063000

英文单位：Fifth Department of Radiotherapy and Chemotherapy Tangshan People′s Hospital Hebei Province Tangshan 063000 China

关键词：广泛期小细胞肺癌；阿帕替尼；维持治疗；血清标志物

英文关键词：Extensivesmallcelllungcancer;Apatinib;Maintenancetherapy;Serummarkers

• 摘要：

• 目的  探讨阿帕替尼联合依托泊苷应用于广泛期小细胞肺癌维持治疗的效果及对血管内皮生长因子（VEGF）和VEGF受体2（VEGFR2）水平的影响。方法  选取2019年1月至2021年2月河北省唐山市人民医院收治的60例经标准放化疗后广泛期小细胞肺癌患者，按随机数字表法分为对照组与观察组，各30例。对照组予依托泊苷胶囊维持化疗，观察组在对照组基础上联合阿帕替尼口服治疗。评估2组临床疗效。比较2组治疗前后VEGF及VEGFR2水平，记录2组不良反应，比较2组生存情况。结果  观察组客观缓解率、疾病控制率均高于对照组［33.3%（10/30）比13.3%（4/30）、60.0%（18/30）比36.7%（11/30）］，差异均有统计学意义（均P<0.05）。治疗后2组患者VEGF和VEGFR2水平均显著低于治疗前，且观察组低于对照组，差异均有统计学意义（均P<0.05）。2组各不良反应发生情况差异均无统计学意义（均P>0.05）。观察组患者1年及2年生存率均显著高于对照组，差异均有统计学意义（均P<0.05）。结论  在广泛期小细胞肺癌维持治疗中应用阿帕替尼联合依托泊苷可抑制患者血清肿瘤因子表达，提升患者临床疗效及生存率，且不良反应可耐受。

• Objective To explore the effect of apatinib combined with etoposide in maintenance therapy of extensive small cell lung cancer and its impact on levels of vascular endothelial growth factor (VEGF) and VEGF receptor 2(VEGFR2). Methods A total of 60 patients with extensive small cell lung cancer treated by standard radiotherapy and chemotherapy admitted to Tangshan People′s Hospital, Hebei Province from January 2019 to February 2021 were enrolled. They were divided into control group and observation group according to the random number table method, with 30 patients in each group. The control group was given etoposide capsule for maintenance chemotherapy, and the observation group was treated with apatinib on the basis of the control group. The clinical effects of the two groups were evaluated. Serum levels of VEGF and VEGFR2 before and after treatment were compared between the two groups. Adverse reactions were recorded between the two groups. The survivals of the two groups were compared. Results  The objective  response rate and disease control rate of the observation group were higher than those of the control group［33.3%(10/30) vs 13.3%(4/30), 60.0%(18/30) vs 36.7%(11/30)］(both P<0.05). After treatment, the levels of VEGF and VEGFR2 in both groups of patients were significantly lower than those before treatment, and the observation group was lower than the control group(all P<0.05). There were no statistically significant differences in the occurrences of adverse reaction between the two groups(all P>0.05). The 1-year and 2-year survival rates of the observation group were significantly higher than those of the control group (both P<0.05). Conclusion The application of apatinib combined with etoposide in the maintenance treatment of extensive small cell lung cancer can inhibit the expression of tumor factors in patients′ serum, and improve the clinical efficacy and survival rate of patients. The adverse reactions are tolerable.