关键词: 胃癌, 食管胃结合部腺癌, 肝转移, 阿帕替尼, 疗效

Abstract: ObjectiveTo investigate the clinical efficacy and safety of apatinib in the treatment of gastric cancer and esophagogastric junction adenocarcinoma with liver metastases. 
MethodsFrom Mar. 2011 to Feb. 2017， 42 cases of gastric cancer and esophagogastric junction adenocarcinoma with liver metastases including 18 newly diagnosed patients and 24 relapsed refractory patients were analyzed retrospectively. The oral dose range of apatinib was 250850 mg and the appropriate dose adjustment could be made according to the patients physical status and side effects. Combined chemotherapy regimens included single drug S.1， XELOX regimen， SOX regimen， and hepatic artery and gastric artery chemoembolization （TACE）. The efficacy and adverse effects were respectively evaluated by RECIST 1.1 and NCICTCAE 4.0 criteria. The relationship between the clinicopathologic features with clinical efficacy was analyzed. The followedup was performed and Cox regression model was used for multifactor survival analysis. 
ResultsIn the combined chemotherapy group， the median chemotherapy cycle was 4 （2.6）， and the median chemotherapy cycle in the TACE group was 3 （1.3）. There were 3 patients （7.14％） of PR， 22 （52.38％） cases of SD and 17 （40.48％） cases of PD. The total response rate （RR） was 7.14％， and the disease control rate （DCR） was 5952％. With a median followup time of 4（1.16） months， the median overall survival （OS） was 7 months and the median progressionfree survival （PFS） was 2 months. The clinicapathologic features such as gender, age, primary lesion, gastrectomy, TACE and chemotherapy with different initial does of apatinib was not related to RR or DCR（P＞0.05）. Independent prognostic factors of PFS was not found in survival analysis. Apatinib combined with chemotherapy was independent factor of OS. Apatinib monotherapy was associated with a higher risk of death than combined chemotherapy. The side effects included leukocyte decline， anemia， thrombocytopenia， hand foot syndrome， hypertension， fatigue and diarrhea. Most of adverse reactions were in 12 grade, whose incidence was low and tolerable. 
ConclusionApatinib combined with chemotherapy in the treatment of gastric cancer and esophagogastric junction adenocarcinoma with liver metastases was clinical efficacy， and can significantly extend the survival time.

Key words: Gastric cancer, Esophagogastric junction adenocarcinoma, Liver metastases, Apatinib, Treatment outcome