紫杉醇和 S-1 联合阿帕替尼用于不可切除的晚期胃癌转化治疗的疗效。
Efficacy of paclitaxel and S-1 combined with apatinib in the conversion therapy for unresectable advanced gastric cancer.
机构信息
Department of Oncological Surgery, The First People's Hospital of Fuyang, Hangzhou, China.
出版信息
J BUON. 2021 Jul-Aug;26(4):1485-1490.
PURPOSE
To explore the safety and effectiveness of paclitaxel and tegafur, gimeracil and oteracil potassium (S-1) combined with apatinib in the conversion therapy for unresectable advanced gastric cancer.
METHODS
A total of 66 patients with advanced gastric cancer received treatment with paclitaxel + S-1 + apatinib. Patients evaluated as resectable advanced gastric cancer by the multiple disciplinary team (MDT) underwent the surgery. The clinical efficacy and adverse reactions of the patients receiving conversion therapy and the related indicators of those undergoing operation were recorded. Later, the survival of the patients was compared between successful conversion therapy (surgery) group and unsuccessful conversion therapy (non-surgery) group.
RESULTS
All the 66 patients completed 3-7 cycles of chemotherapy, with a median of 5 cycles, and the objective response rate (ORR) after conversion therapy was 71.2% (47/66). Among them, 48 patients received operation for (225.2±37.3) min on average, with the intraoperative blood loss of (168.2±40.9) mL and (50.9±12.3) intraoperative dissected lymph nodes, including 34 (70.8%) cases of R0 resection. According to the postoperative pathological tumor regression grading (TRG), there were 2 (4.2%) TRG 0 cases, 10 (20.8%) TRG 1 cases, 28 (58.3%) TRG 2 cases and 8 (16.7%) TRG 3 cases. The follow-up results revealed that the one-year overall survival (OS) of the patients was 93.8% (45/48) in successful conversion therapy (surgery) group and 61.1% (11/18) in unsuccessful conversion therapy (non-surgery) group.
CONCLUSION
Paclitaxel and S-1 combined with apatinib can achieve a higher R0 resection rate, and improve the survival rate of patients with successful conversion therapy, showing high safety and efficacy.
目的
探讨紫杉醇、替加氟、吉美嘧啶、奥替拉西钾（S-1）联合阿帕替尼用于不可切除的晚期胃癌转化治疗的安全性和有效性。
方法
共纳入 66 例晚期胃癌患者，采用紫杉醇+S-1+阿帕替尼治疗。经多学科团队（MDT）评估为可切除的晚期胃癌患者接受手术治疗。记录转化治疗患者的临床疗效和不良反应及手术患者的相关指标，比较成功转化治疗（手术）组和失败转化治疗（非手术）组患者的生存情况。
结果
66 例患者均完成 3-7 个周期的化疗，中位 5 个周期，转化治疗后客观缓解率（ORR）为 71.2%（47/66）。其中 48 例患者行手术治疗，平均手术时间（225.2±37.3）min，术中出血量（168.2±40.9）mL，术中清扫淋巴结（50.9±12.3）枚，其中 R0 切除 34 例（70.8%）。术后病理肿瘤退缩分级（TRG）0 级 2 例（4.2%），1 级 10 例（20.8%），2 级 28 例（58.3%），3 级 8 例（16.7%）。随访结果显示，成功转化治疗（手术）组患者的 1 年总生存（OS）率为 93.8%（45/48），失败转化治疗（非手术）组为 61.1%（11/18）。
结论
紫杉醇、S-1 联合阿帕替尼可获得更高的 R0 切除率，提高成功转化治疗患者的生存率，具有较高的安全性和有效性。
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