评价阿帕替尼联合替吉奥治疗晚期食管癌的疗效与安全性及其影响因素。

对当涂县人民医院2020年3月至2023年3月收治的91例晚期食管癌患者给予阿帕替尼联合替吉奥治疗，以治疗4周期后客观缓解为疗效评价标准、以治疗期间药物不良反应发生为安全性评价标准，评估2组客观缓解率、药物不良反应发生率。比较客观缓解、非客观缓解和发生、未发生药物不良反应患者临床资料，使用Logistic多因素回归模型，归纳影响阿帕替尼联合替吉奥治疗晚期食管癌疗效与安全性的相关因素。

91例患者均完成4周期治疗。治疗后，无患者达成完全缓解，部分缓解30例，疾病稳定42例，疾病进展19例；客观缓解率为32.97%。患者治疗期间药物不良反应以手足综合征、恶心、继发性高血压、白细胞减少、呕吐为主，3～4级不良反应少见，65例（71.43%）患者发生一项或多项不良反应。Logistic多因素回归分析示，复发转移部位≥2个是非客观缓解的独立影响因素，局部转移为保护因素；一线化疗方案紫杉醇＋顺铂是发生不良反应的独立影响因素，体表面积1.25～<1.5 m²为保护因素。

阿帕替尼联合替吉奥治疗晚期食管癌的疗效和安全性值得肯定，影响疗效和安全性的因素以复发转移部位、转移距离、体表面积、一线化疗方案为主。

To evaluate the efficacy and safety of apatinib combined with S-1 in the treatment of advanced esophageal cancer and its influencing factors.

From March 2020 to March 2023, 91 patients with advanced esophageal cancer in Dangtu County People's Hospital were treated with apatinib combined with S-1. The objective remission rate and the incidence of adverse drug reactions in the two groups were evaluated with the objective remission after 4 cycles of treatment as the efficacy evaluation standard and the occurrence of adverse drug reactions during treatment as the safety evaluation standard. The clinical data of patients with objective remission, non-objective remission, occurrence and absence of adverse drug reactions were compared, and Logistic multivariate regression model was used to summarize the related factors affecting the efficacy and safety of apatinib combined with S-1 in the treatment of advanced esophageal cancer.

All 91 patients completed 4 cycles of treatment. After 4 cycles of treatment, no patients achieved complete remission, 30 patients were partial remission, 42 patients were stable disease and 19 patients were progressive disease. The objective remission rate of patients was 32.97%. During the treatment, the main adverse drug reactions were hand-foot syndrome, nausea, secondary hypertension, leukopenia and vomiting, and grade 3-4 adverse reactions were rare. Among 91 patients, 65 (71.43%) had one or more adverse reactions. Logistic multivariate regression analysis showed that recurrence and metastasis sites ≥2 were independent influencing factors of non-objective remission, and local metastasis was the protective factor; The first-line chemotherapy regimen of paclitaxel+cisplatin was an independent influencing factor of adverse reactions, and the body surface area of 1.25-<1.5 m² was a protective factor.

The efficacy and safety of apatinib combined with S-1 in the treatment of advanced esophageal cancer are worthy of recognition. The main factors affecting the efficacy and safety are the location of recurrence and metastasis, the distance of metastasis, the body surface area and the first-line chemotherapy regimen.