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盐酸安罗替尼治疗晚期非小细胞肺癌的近期疗效及相关预测指标

Short-term Efficacy and Predictive Index of Anlotinib Hydrochloride Capsule on Advanced Non-small Cell Lung Cancer

  • 摘要:
    目的 探讨盐酸安罗替尼治疗晚期非小细胞肺癌的近期疗效及相关预测因素。
    方法 回顾性分析83例二线治疗后进展的非小细胞肺癌患者的临床资料。采用Kaplan-Meier法计算PFS率,Log rank法进行生存率曲线统计学检验,Cox回归模型分析多因素对无进展生存期影响,ROC曲线分析多项指标对预后的预测价值。
    结果 83例晚期非小细胞肺癌患者中,0例完全缓解,10例部分缓解,56例疾病稳定,17例疾病进展。不良反应可控。客观缓解率与疾病控制率分别为12.0%和79.5%。中位无进展生存期(mPFS)为4.43月。单因素分析结果显示,ECOG评分≥2分、合并胸腔积液、低白蛋白血症、谷酰胺转肽酶GGT升高、非小细胞肺癌抗原21-1(CYFRA21-1)升高、血小板压积(Pct)降低、合并肺脉管癌栓患者的PFS明显缩短。Cox多因素回归分析显示,ECOG体力状况评分、胸腔积液、低白蛋白血症、CYFRA21-1、肺脉管癌栓是PFS的独立预后因素。
    结论 对于二线治疗后进展的非小细胞肺癌患者,三线应用安罗替尼治疗安全有效。ECOG评分≥2分、CYFRA21-1升高、低白蛋白血症、合并肺脉管癌栓及胸腔积液的患者预后较差,且CYFRA21-1具有较高的预测价值。

     

    Abstract:
    Objective To evaluate the short-term efficacy and predictive index of anlotinib hydrochloride capsule on advanced NSCLC patients.
    Methods We retrospectively reviewed the clinical characteristics of 83 patients with non-small cell lung cancer who had received the second-line chemotherapy. Kaplan-Meier method was used to calculate the rate of PFS. Log rank method was used for statistical test of survival curve. Cox regression model was used to analyze the influence of multiple factors on progress free survival (PFS). ROC curve was used analyze the prognostic value of multiple indicators.
    Results Among 83 patients with advanced NSCLC, there were 0 case of CR, 10 cases of PR, 56 cases of SD and 17 cases of PD. The side-effect could be controlled. The ORR and DCR were 12.0% and 79.5%, respectively. The mPFS was 4.43 months. In univariate analysis, the patients with ECOG score≥2, hypoalbuminemia, pleural effusion, elevated GGT and CYFRA21-1, decreased Pct and vascular tumor embolus had shorter PFS. Multivariable Cox regression analysis showed ECOG score, hypoalbuminemia, pleural effusion, CYFRA21-1 and vascular tumor embolus were independent prognostic factors.
    Conclusion For patients with non-small cell lung cancer progressing after the second-line treatment, the third-line treatment with anlotinib is safe and effective. Patients with ECOG score≥2, increased CYFRA21-1, hypoalbuminemia, pleural effusion and vascular tumor emboli have a poor prognosis. CYFRA21-1 has relatively high predictive value.

     

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