目的:观察阿帕替尼单药与多西他赛联合顺铂对晚期胃癌患者的近期疗效及毒副反应。方法：按纳入和排除标准，选取解放军第105 医院晚期胃癌患者108 例，按随机表分组法分为A组54 例、B组54 例。A组患者持续阿帕替尼单药口服，B组患者给予多西他赛联合顺铂化疗，化疗3 周为1 个周期，4 个周期为1 个疗程，疗程结束后3 个月评价疗效及毒副反应。结果：A组CR 4 例、PR 25 例、SD 18 例、PD 7 例，ORR为53.7%，DCR为87.0%；B组CR 2 例、PR 19 例、SD 21 例、PD 12 例、ORR为38.9%，DCR为77.8%。A组患者ORR及DCR明显优于B组（均P<0.05）。所有患者主要不良反应为胃肠反应、骨髓抑制、高血压、手足综合征，均为1~2级；A组患者骨髓抑制及胃肠反应发生率低于B组（P<0.05），B组患者手足综合征及高血压发生率低于A组（P<0.01）。结论：阿帕替尼单药靶向治疗近期有效率高于多西他赛联合顺铂化疗，两种治疗方案毒副反应均可控；阿帕替尼可作为晚期胃癌患者首选治疗方案。

Objective: To observe the short-term efficacy and toxicity of apatinib monotherapy as well as docetaxel plus cisplatin in advanced gastric cancer. Method: According to inclusion and exclusion criteria, 108 patients with advanced gastric cancer in the 105th Hospital of PLA were selected. According to random table grouping method, there were 54 cases in group A and 54 cases in group B.Patients in group A received continuous oral administration of apatinib alone, while group B received docetaxel plus cisplatin chemotherapy,with 3 weeks as a cycle and 4 cycles for a course. The efficacy and side effects were evaluated 3 months later. Results: In group A, there were 4 cases of CR, 25 cases of PR, 18 cases of SD and 7 cases of PD; the ORR was 53.7% and DCR was 87%. In group B, there were 2 cases of CR, 19 cases of PR, 21 cases of SD and 12 cases of PD; the ORR was 38.9% and DCR was 77.8%. The ORR and DCR in group A were significantly better than those in group B (P<0.05). The main adverse reactions were gastrointestinal reaction,myelosuppression, hypertension and hand-foot syndrome, all of which were grade 1 to 2; The incidence of bone marrow suppression and gastrointestinal reaction in group A was lower than that in group B (P<0.05), while the incidence of hand-foot syndrome and hypertension in group B was lower than that in group A (P<0.01). Conclusion：The short-term efficacy of targeted therapy of apatinib alone was better than that of docetaxel combined with cisplatin chemotherapy, and the toxicity and side effects of both regimens were controllable; Apatinib can be used as the primary regimen for the treatment of advanced gastric cancer.

安徽省自然科学基金资助项目（No. 1808085MH239）