Curative Effect Analysis Of Apatinib Alone In The Treatment Of Recurrent Glioblastoma And The Exploratory Study Of Related Predictors

Glioblastoma is the most malignant tumor in the human central nervous system with poor prognosis.At present,the main treatment of glioblastoma is resection of tumor,postoperative radiotherapy and chemotherapy,but the effect is not satisfactory.And when the tumor recurs,the treatment options are even more limited.At present,there is no uniform and effective treatment for recurrent glioblastoma.The histopathological characteristics of glioblastoma are microvascular hyperplasia and express high levels of angiogenic factors.In 1971,Folkman first hypothesized that inhibition of angiogenesis would be an effective anti-cancer therapy.In recent years,the research and application of antiangiogenic drugs have provided more options for the treatment of glioblastoma.Clinical studies have also confirmed the effect of these drugs on the prognosis of patients,but the prognosis and response to treatment vary among individuals who with the same histological types according to current classification methods.Therefore,finding effective markers and further classifying therapy is the key to improve the overall clinical efficacy and optimize individualized treatment.The purpose of this study was to analyze the efficacy of a new antiangiogenic drug,Apatiinib,in the treatment of recurrent glioblastoma and to explore potential predictors.Objective:We analyzed the survival of a group of patients that treated with Apatinib antiangiogenic therapy and explored the predictive effect of neutrophils in the blood on the antiangiogenic effect of glioblastoma.Methods:The patients with glioblastoma diagnosed pathologically from 2015 to 2017 in the first affiliated Hospital of Zhengzhou University were collected,and the patients recurred after the standard radiotherapy and chemotherapy regimen,and were immediately treated with antiangiogenic drugs.Anti-angiogenic drugs selection A new anti-angiogenic drug Apatinib which made in China.Results:We evaluated the efficacy of 26 patients.Among them,12 cases achieved partial remission,3 cases were complete remission,7 patients in stable state of disease,In 4cases,the disease was not effectively controlled.Total effective of recurrent glioblastoma response: 15 cases,Objective response rate of 57.6%,The 6-month progression-free survival rate was 50%.The median progressive survival time was 5.9months and the median total survival time was 9 months.The analysis of the prognostic factors of blood neutrophils was not statistically different.In terms of safety evaluation,except for 1 case of malignant hypertension with severe diarrhea,1case of upper gastrointestinal bleeding and 1 case of grade 3 adverse reaction of nausea and vomiting,and the other adverse reactions could be effectively controlled.The adverse reactions with high incidence were hypertension 42.3% and skin reaction of hands and feet 30.8%.Conclusion:The results of this study showed that apatinib showed a good biological activity in the treatment of recurrent glioblastoma,and the survival benefit of the patients was obvious.There is no statistical difference in the analysis of the prognostic factors of neutrophils as a prognostic factor,and may also be related to the lack of sample size.At the same time,the safety of apatinib clinical application is also controllable.