摘要【目的】探讨伊立替康联合贝伐单抗治疗铂类耐药复发性卵巢癌的疗效。【方法】选取2016年9月至2018年9月在本院接受治疗的118例铂类耐药复发性卵巢癌患者为研究对象,采用随机数字表法随机分为对照组和观察组,每组各59例。对照组采用伊立替康治疗;观察组采用伊立替康联合贝伐单抗治疗。比较两组患者近期及远期疗效、血清肿瘤标志物[人附睾分泌蛋白4(HE4)、糖类抗原125(CA125)、癌胚抗原(CEA)]变化和不良反应情况。【结果】治疗后:观察组患者客观缓解率(ORR)明显高于对照组(57.63% vs 37.29%,P<0.05);两组患者血清HE4、CA125、CEA水平均低于治疗前,且观察组明显低于对照组(P<0.05);观察组患者总生存时间(OS)和无进展生存期(PFS)明显长于对照组(P<0.05);两组患者在血红蛋白减少、肾功能损伤、谷丙转氨酶升高、中心粒细胞减少、血小板减少及周围神经炎发生率比较差异无显著性(P>0.05);观察组0级白细胞减少的发生率显著高于对照组(P<0.05);观察组Ⅲ~Ⅳ级腹泻、恶心呕吐发生率显著低于对照组(P<0.05)。【结论】采用伊立替康联合贝伐单抗治疗铂类耐药复发性卵巢癌患者,疗效确切,还可改善患者PFS和OS,且不良反应可耐受,值得临床推广应用。
Abstract:【Objective】To investigate the efficacy of Irinotecan combined with bevacizumab in the treatment of platinum-resistant recurrent ovarian cancer. 【Methods】A total of 118 patients with platinum-resistant recurrent ovarian cancer treated in our hospital from Sep. 2016 to Sep. 2018 were randomly divided into the control group and the observation group with 59 cases in each group. The control group was treated with Irinotecan, while the observation group was treated with Irinotecan combined with bevacizumab. The short-term efficacy, serum tumor markers such as human epididymal secretory protein 4 (HE4), carbohydrate antigen 125 (CA125) and carcinoembryonic antigen (CEA), long-term efficacy and adverse reactions of the two groups were compared. 【Results】 After treatment, the objective remission rate (ORR) in the observation group was significantly higher than that in the control group (57.63% vs 37.29%, P<0.05). The levels of HE4,CA125, and CEA in both groups were lower than those before treatment, and those in the observation group were significantly lower than those in the control group (P<0.05). The total survival time (OS) and progression-free survival (PFS) of patients in the observation group were significantly longer than those in the control group (P<0.05). The incidence of hemoglobin decrease, renal function damage, alanine aminotransferase increase, central granulocyte decrease, thrombocytopenia, and peripheral neuritis in the two groups were compared (P>0.05). The incidence of grade 0 leukopenia in the observation group was significantly higher than that in the control group (P<0.05). The incidence of grade Ⅲ-Ⅳ diarrhea and nausea and vomiting in the observation group was significantly lower than that in the control group (P<0.05). 【Conclusion】Irinotecan combined with bevacizumab is effective in the treatment of platinum-resistant recurrent ovarian cancer. It can also improve PFS and OS in patients with platinum-resistant ovarian cancer, and the adverse reactions are tolerable. It is worthy of clinical application.