進行性口腔癌に対するapatinib mesylateと化学療法との併用効果の検討

Effect of different doses of apatinib mesylate combined with chemotherapy on advanced oral cancer.

抄録

目的:

進行性口腔癌に対するアパチニブメシル酸塩と化学療法との併用療法の治療効果および安全性を検討する。

OBJECTIVE: To investigate the therapeutic effect and safety of different doses of apatinib mesylate combined with chemotherapy in the treatment of advanced oral cancer.

方法:

2019年1月から2020年7月までに当院に入院した進行性口腔癌患者計100例をレトロスペクティブに解析し、対照群（アパチニブメシル酸500mgと化学療法の併用）と実験群（アパチニブメシル酸250mgと化学療法の併用）に分けました。両群を副作用発現率、治療有効率、病勢コントロール率、客観的奏効率、Karnofsky Performance Status（KPS）スコア（QOL）、MSSNS（精神科以外での精神状態尺度）スコア、生存率、治療後の血管内皮増殖因子（VEGF）および血管内皮増殖因子受容体2（VEGFR-2）について比較検討したところ、VEGFおよびVEGFRは、対照群に比べ有意に低下していた。また、口腔癌治療後のKPS<85の影響因子をロジスティック回帰で分析した。

METHODS: Totally 100 patients with advanced oral cancer admitted to our hospital from January 2019 to July 2020 were retrospectively analyzed and divided into a control group (500 mg apatinib mesylate combined with chemotherapy) and an experimental group (250 mg apatinib mesylate combined with chemotherapy). The two groups were compared in terms of the incidence of adverse reactions, treatment effective rate, disease control rate, objective response rate, Karnofsky performance status (KPS) score (quality of life), score of the mental status scale in non-psychiatric settings (MSSNS), survival rates and vascular endothelial growth factor (VEGF) and vascular endothelial growth factor receptor 2 (VEGFR-2) after treatment. In addition, logistic regression was used to analyze the influencing factors for KPS<85 after oral cancer treatment.

結果:

実験群の治療効果率、病勢コントロール率、客観的奏効率、KPSスコア（QOL）、生存率はいずれも対照群に比べ有意に改善し（いずれもP＜0.05）、実験群の治療後の副作用発現率、MSSNSスコア、VEGF、VEGFR-2濃度は対照群に比べ有意に低値であった（いずれもP＜0.05）。さらに，喫煙歴，飲酒歴，歯磨き指数＜3，歯の洗浄回数≦1回/年，口腔疾患歴＜3回，栄養状態の悪さは，口腔がん治療後のKPS＜85の独立した危険因子であった．

RESULTS: The treatment effective rate, disease control rate, objective response rate, KPS score (quality of life), survival rates in the experimental group were all significantly improved compared to those in the control group (all P<0.05), and the incidence of adverse reactions, MSSNS score, and the levels of VEGF and VEGFR-2 after treatment in the experimental group were significantly lower than those in the control group (all P<0.05). Furthermore, a history of smoking, a history of drinking, a tooth brushing index <3, the frequency of teeth cleansing ≤1 time per year, a history of oral diseases >3 times, and poor nutritional status were independent risk factors for KPS<85 after oral cancer treatment.

結論:

アパチニブメシル酸塩（250 mg）と化学療法の併用は、進行した口腔癌患者に対して、最も安全で副作用が少なく、最適な効果に到達することができる。

CONCLUSION: Apatinib mesylate (250 mg) combined with chemotherapy can reach optimal efficacy with highest safety but least adverse effects for patients with advanced oral cancer.