贝伐珠单抗联合TC方案治疗晚期复发性卵巢癌患者的效果

doi:10.3760/cma.j.issn.1007-1245.2024.07.027

摘要/Abstract

摘要：

目的　探讨贝伐珠单抗联合TC（紫杉醇/卡铂）方案治疗晚期复发性卵巢癌患者的效果。方法　选取2017年11月至2022年11月汉中市中心医院收治的92例复发性晚期卵巢癌患者进行随机对照试验，采用随机数字表法将其分为对照组和观察组，各46例。对照组年龄（52.34±8.45）岁，国际妇产科联盟（International Federation of Gynecology and Obstetrics，IFGO）分期Ⅲ期24例、Ⅳ期22例。观察组年龄（53.21±9.67）岁，FIGO分期Ⅲ期23例、Ⅳ期23例。对照组采用TC方案治疗，观察组在对照组基础上加用贝伐珠单抗治疗；两组均治疗6个周期，约18周。对比两组患者治疗后临床疗效、肿瘤血清标志物［糖类抗原125（carbohydrate antigen 125，CA125）、人附睾蛋白4（human epididymis protein 4，HE4）、糖类抗原199（carbohydrate antigen 199，CA199）、血管内皮生长因子（vascular endothelial growth factor，VEGF）］水平、治疗后1年生存率、生存质量［采用卡氏功能状态量表（Karnofsky Performance Status Scale，KPS）］评分和不良反应发生情况。采用t检验、χ²检验。结果　治疗6个周期后，观察组疾病缓解率为78.26%（36/46），高于对照组的54.35%（25/46）（χ²=7.771，P=0.005）；观察组CA125、HE4、CA199和VEGF水平均低于对照组（均P<0.05）；观察组治疗后1年生存率为73.91%（34/46），高于对照组46.65%（21/46）（χ²=7.640，P=0.006）；观察组KPS评分为（72.52±8.13）分，高于对照组的（64.60±7.58）分（t=4.832，P<0.001）；两组主要不良反应为骨髓抑制、消化道反应和肝肾损伤；观察组与对照组各不良反应发生率相比，差异均无统计学意义（均P>0.05）。结论　贝伐珠单抗联合TC方案治疗复发性晚期卵巢癌患者临床效果较好，可提高患者1年生存率和生活质量，降低肿瘤血清标志物水平，且不良反应可控。

关键词:

贝伐珠单抗, 晚期复发性卵巢癌, 疗效, 肿瘤标志物, 不良反应

Abstract:

Objective　To explore the effect of bevacizumab combined with the TC (paclitaxel/carboplatin) regimen in the treatment of patients with advanced recurrent ovarian cancer. Methods　Ninety-two patients with recurrent advanced ovarian cancer treated at Hanzhong Central Hospital from November 2017 to November 2022 were selected for the randomized controlled trial, and were divided into a control group and an observation group by the random number table method, with 46 cases in each group. The control group were (52.34±8.45) years old; there were 24 cases of stage Ⅲ and 22 cases of stage Ⅳ of International Federation of Gynecology and Obstetrics (IFGO). The observation group were (53.21±9.67) years old; there were 23 cases of stage Ⅲ and 23 cases of stage Ⅳ of FIGO. The control group were treated by the TC regimen; in addition, the observation group took bevacizumab. The clinical efficacies, serum levels of tumor markers [carbohydrate antigen 125 (CA125), human epididymis protein 4 (HE4), carbohydrate antigen 199 (CA199), and vascular endothelial growth factor (VEGF)], one-year survival rates, and quality of life [evaluated by Karnofsky Performance Status (KPS)] after the treatment, and adverse reactions were compared between the two groups. t and χ² tests were applied. Results　After six cycles of treatment, the disease remission rate in the observation group was higher than that in the control group [78.26% (36/46) vs. 54.35% (25/46); χ²=7.771, P=0.005]; the levels of CA125, HE4, CA199, and VEGF in the observation group were lower than those in the control group (all P<0.05). The one-year survival rate after the treatment in the observation group was higher than that in the control group [73.91% (34/46) vs. 46.65% (21/46); χ²=7.640, P=0.006]. The score of KPS in the observation group was higher than that in the control group [(72.52±8.13) vs. (64.60±7.58); t=4.832, P<0.001]. The main adverse reactions in both groups were bone marrow suppression, gastrointestinal reactions, and hepatic and renal damage; there were no statistical differences in the incidences of these reactions between the two groups (all P>0.05). Conclusion　Bevacizumab combined with the TC regimen in the treatment of patients with recurrent advanced ovarian cancer has good clinical efficacy, can improve their one-year survival rate and quality of life and reduce the serum levels of tumor markers, and has controllable adverse reactions.

Key words:

Bevacizumab, Advanced recurrent ovarian cancer, Efficacy, Tumor markers, Adverse reactions

岳红陈文华范志刚张淑莲常捷芳.

贝伐珠单抗联合TC方案治疗晚期复发性卵巢癌患者的效果 [J]. 国际医药卫生导报, 2024, 30(7): 1190-1194.

Yue Hong, Chen Wenhua, Fan Zhigang, Zhang Shulian, Chang Jiefang.

Bevacizumab combined with TC regimen in treatment of patients with advanced recurrent ovarian cancer [J]. International Medicine and Health Guidance News, 2024, 30(7): 1190-1194.

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