Abstract: Background　With the discovery of research，the occurrence and development of tumors is mainly about neovascularization.Tumor angiogenesis is one of the important causes of carcinogenesis.Apatinib，as a target drug of tyrosine kinase inhibitor of vascular endothelial growth factor developed in China，is also the first oral anti-angiogenesis drug for advanced gastric cancer in the world.Objective　To observe the clinical efficacy and toxicity of apatinib in the treatment of advanced gastric cancer with multiline chemotherapy failure.Methods　A total of 42 patients with advanced gastric or gastro-esophageal junction adenocarcinoma treated in the Affiliated Tumor Hospital of Xinjiang Medical University from January 2015 to November 2016 were selected.According to Eastern Cooperative Oncology Group（ECOG） score，42 patients with advanced gastric cancer were given different doses of apatinib and apatinib combined with tegafur therapy.Follow-up ended at 1 January，2017，and the efficacy，adverse reactions and overall survival rate of patients during medication were observed and recorded.Results　As of 1 January，2017，31 patients（73.8%） died and 11 patients（26.2%） survived.The survival time was 5.53〔95%CI（4.20，6.86）〕 months.Forty-two patients had different degrees of toxicity and side effects in targeted therapy.Among them，there were 16 cases（38.1%） of nausea and vomiting，16 cases（38.1%） of fatigue，8 cases（19.0%） of elevated blood pressure，8 cases（19.0%） of leukopenia and thrombocytopenia，4 cases（9.5%） of elevated transaminase and 11 cases（26.2%） of other symptoms.The symptoms of fatigue，hypertension and other symptoms in patients were improved by reducing the dosage of apatinib properly，and patients could continue to tolerate treatment.Conclusion　Apatinib has a significant effect for the treatment of advanced gastric carcinoma and gastro-esophageal junction cancer with multiple line failure of chemotherapy，but it still needs further study by clinical workers.

Key words: Stomach neoplasms, Apatinib, Treatment outcome, Toxic effect, Survival analysis, Failure of multiline chemotherapy

摘要： 背景　随着研究发现，肿瘤的发生、发展对新生血管有明显依赖，肿瘤血管生成是致癌重要原因之一，阿帕替尼作为我国研制成的血管内皮生长因子酪氨酸激酶抑制剂的靶向药物，也是全球首个晚期胃癌的口服抗血管生成药物。目的　观察甲磺酸阿帕替尼治疗多线化疗失败的晚期胃癌患者的临床疗效及毒副作用。方法　选取2015年1月—2016年11月新疆医科大学附属肿瘤医院收治的晚期胃或胃食管结合部癌患者42例，根据美国东部肿瘤协作组（ECOG）评分，对患者给予不同剂量阿帕替尼单药和联合替吉奥治疗。随访至2017-01-01，观察记录患者用药期间的疗效、相关毒副作用及总生存率。结果　截至2017-01-01，31例（73.8%）患者死亡，11例（26.2%）患者存活。生存时间为5.53〔95%CI（4.20，6.86）〕个月。42例患者在靶向治疗中均出现了不同程度的毒副作用。其中恶心呕吐16例（38.1%），乏力16例（38.1%），血压升高8例（19.0%），白细胞减少、血小板降低8例（19.0%），转氨酶升高4例（9.5%），其他11例（26.2%）。通过适量降低阿帕替尼服用剂量，合理降压药物对症后，患者乏力、高血压等症状有所改善，尚可继续耐受治疗。结论　甲磺酸阿帕替尼治疗多线化疗失败的晚期胃癌及胃食管结合部癌疗效可，但仍有待临床工作者进一步探讨研究。

关键词: 胃肿瘤, 甲磺酸阿帕替尼, 治疗结果, 毒副作用, 生存分析, 多线化疗失败