Abstract:

Objective　To retrospectively analyze the effects of apatinib combined with gemcitabine plus oxaliplatin regimen on serum tumor markers and prognosis of patients with advanced ovarian cancer. Methods　A total of 76 patients with advanced ovarian cancer admitted to Nanyang Central Hospital from February 2022 to February 2024 were retrospectively selected and divided into control group and observation group according to different treatment methods, with 38 cases in each group. The age of control group was (51.27±3.28) years old, with pathological staging of 16 cases in stage III and 22 cases in stage IV; they received treatment with gemcitabine and oxaliplatin, with gemcitabine administered intravenously at a dose of 1,000 mg/m² on days 1 and 8, and oxaliplatin at a dose of 130 mg/m² on day 1. Continuous treatment for 3 weeks constituted one cycle. The age of the observation group was ((50.92±3.35) years old, with 18 cases in stage III and 20 cases in stage IV; they received apatinib in addition to the treatment in the control group, orally at a dose of 500 mg once daily. After 14 days of continuous use without severe adverse reactions, the dose was adjusted to 750 mg once daily until disease progression or intolerance occurred. Both groups underwent a total of 3 treatment cycles. Clinical efficacy, tumor markers [carbohydrate antigen (CA125), carcinoembryonic antigen (CEA), cytokeratin 19 fragment antigen 21-1 (CYFRA21-1)], vascular endothelial growth factor receptor (VEGFR), platelet-derived growth factor receptor (PDGFR), inflammatory factors [interleukin-6 (IL-6), IL-10, interferon-γ (INF-γ)] levels, the Chinese Cancer Patient Chemotherapy Quality of Life Scale (QLQ-CCC) scores, and adverse reactions were compared between the two groups. Statistical analysis was performed using χ² tests and t tests. Results　The disease control rate in the observation group was higher than that in the control group [84.21% (32/38) vs. 63.16% (24/38)], with a statistically significant difference (χ²=4.343, P=0.037). After three treatment cycles, the levels of CA125, CEA, CYFRA21-1, VEGFR, PDGFR, IL-6, IL-10, and INF-γ in the observation group were (31.54±2.05) U/ml, (2.46±0.52) ng/L, (15.87±1.26) g/L, (408.56±70.45) ng/L, (64.62±4.28) ng/L, (1.24±0.25) mg/L, and (1.38±0.27) mg/L, (13.48±1.54)mg/L, respectively, compared to (52.68±2.37) U/ml, (4.57±0.76) ng/L, (26.84±1.45) g/L, (495.27±80.23) ng/L, (72.51±5.17) ng/L, (3.27±0.43) mg/L, (3.45±0.38) mg/L, and(7.02±0.92)mg/L in the control group, with all differences being statistically significant (all P<0.05). The QLQ-CCC scores for physiological, social, psychological, and overall sensation in the observation group were all higher than those in the control group (all P<0.05). The overall incidence of adverse reactions between the two groups was not statistically significant (P>0.05). Conclusion　Apatinib combined with gemcitabine plus oxaliplatin regimen in patients with advanced ovarian cancer can improve the disease control rate, reduce tumor marker levels, inhibit the release of inflammatory factors, improve prognosis, and enhance quality of life in patients with advanced ovarian cancer.

Key words: Ovarian cancer,  , Gemcitabine,  , Oxaliplatin,  , Apatinib,  , Efficacy,  , Quality of life

摘要：

目的　分析吉西他滨和奥沙利铂联合阿帕替尼治疗方案对晚期卵巢癌患者血清肿瘤标志物及预后的影响。方法　回顾性选取2022年2月至2024年2月南阳市中心医院收治的晚期卵巢癌患者76例，按照治疗方法不同分为对照组和观察组，每组38例。对照组年龄（51.27±3.28）岁，病理分期：Ⅲ期16例、Ⅳ期22例；采用吉西他滨和奥沙利铂治疗，第1、8天予以吉西他滨1 000 mg/m2，静脉滴注；第1天予以奥沙利铂130 mg/m2，静脉滴注。连续治疗3周为1个疗程。观察组年龄（50.92±3.35）岁，病理分期：Ⅲ期18例、Ⅳ期20例；在对照组基础上联合阿帕替尼治疗，口服，500 mg/次，1次/d；持续服用14 d后，如无严重不良反应，调整剂量至750 mg/次，直至病情进展或者无法耐受。两组患者均连续治疗3个疗程。对比两组临床疗效、肿瘤标志物［糖类抗原125（CA125）、癌胚抗原（CEA）、细胞角蛋白19片段抗原21-1（CYFRA21-1）］、血管内皮生长因子受体（VEGFR）、血小板源性生长因子受体（PDGFR）、炎症因子［白细胞介素-6（IL-6）、IL-10、干扰素-γ（INF-γ）］水平和中国癌症患者化学生物治疗生活质量量表（QLQ-CCC）评分、不良反应。采用χ2检验、t检验进行统计分析。结果　观察组患者的疾病控制率高于对照组［84.21%（32/38）比63.16%（24/38）］，差异有统计学意义（χ2=4.343，P=0.037）。治疗3个疗程后，观察组的CA125、CEA、CYFRA21-1、VEGFR、PDGFR、IL-6、IL-10、INF-γ水平分别为（31.54±2.05）U/ml、（2.46±0.52）ng/L、（15.87±1.26）g/L、（408.56±70.45）ng/L、（64.62±4.28）ng/L、（1.24±0.25）mg/L、（1.38±0.27）mg/L、（13.48±1.54）mg/L，对照组上述指标分别为（52.68±2.37）U/ml、（4.57±0.76）ng/L、（26.84±1.45）g/L、（495.27±80.23）ng/L、（72.51±5.17）ng/L、（3.27±0.43）mg/L、（3.45±0.38）mg/L、（7.02±0.92）mg/L，差异均有统计学意义（均P<0.05）；观察组QLQ-CCC的生理、社会、心理、总体感觉评分均高于对照组（均P<0.05）。两组不良反应总发生率差异无统计学意义（P>0.05）。结论　吉西他滨和奥沙利铂联合阿帕替尼治疗晚期卵巢癌患者，可提高疾病控制率，降低肿瘤标志物水平，抑制炎症因子释放，改善预后，提高生存质量。

关键词: 卵巢癌, 吉西他滨, 奥沙利铂, 阿帕替尼, 疗效, 生存质量