阿帕替尼联合GEMOX方案晚期难治性卵巢癌疗效及安全性评价

目的研究阿帕替尼联合GEMOX方案晚期难治性卵巢癌疗效及安全性。方法选取2013年2月至2017年2月重庆三峡中心医院收治的82例晚期难治性卵巢癌患者作为研究对象。采用随机数字法将其分为对照组和观察组,每组各41例。对照组患者接受GEMOX方案(吉西他滨+奥沙利铂)治疗,观察组患者在此基础上口服阿帕替尼治疗。比较两组患者的有效率(ORR)、疾病控制率(DCR)、中位疾病进展生存时间(TTP)、1年和2年生存率及不良反应发生率,同时比较治疗前后的血清肿瘤标志物表达水平。结果观察组的ORR为36.58%,DCR为70.73%,均明显高于对照组的ORR(19.51%)、DCR(46.34%),差异具有统计学意义(P<0.05);治疗后,观察组患者的血清CA125、CEA及NSE水平均明显低于对照组,差异具有统计学意义(P<0.01);观察组的中位TTP、1年生存率、2年生存率均明显高于对照组,差异具有统计学意义(P<0.05);两组的手足综合征、高血压、胃肠道反应、肝肾功能损害、白细胞减少等不良反应发生率及分级比较均无统计学意义(均P>0.05)。结论阿帕替尼联合GEMOX方案能明显提高晚期难治性卵巢癌近期化疗疗效,控制病情发展,延长患者生存期,且安全性处于可控范围,可作为二线治疗方案。

Evaluation of the efficacy and safety of Apatinib combined with GEMOX regimen for advanced refractory ovarian cancer

Objective To study the efficacy and safety of Apatinib combined with GEMOX regimen for advanced refractory ovarian cancer. Methods 82 patients with advanced refractory ovarian cancer treated in our hospital from February 2013 to February 2017 were selected and randomly divided into control group(n=41) and observation group(n=41). The control group was treated with GEMOX regimen(gemcitabine and oxaliplatin), and the observation group was treated with apatinib orally on the basis of the control group. The effective rate(ORR), disease control rate(DCR), time to progression(TTP), 1-year and 2-year survival rate and incidence of adverse reaction between the two groups were compared and the levels of serum tumor markers before and after treatment were also compared. Results The ORR and ORR in the observation group were 36.58% and 70.73% respectively, which were significantly higher than those in the control group(19.51%, 46.34%), with statistically significant differences(P<0.05). After treatment, the levels of serum CA125, CEA and NSE in the observation group were significantly lower than those in the control group(P<0.01), and the median TTP, the 1-year and 2-year survival rates in the observation group were significantly higher than those in the control group(P<0.05). There was no statically significant difference in the incidences and grading of adverse reactions such as hand-foot syndrome, hypertension, gastrointestinal reaction, liver and kidney damage, leukopenia and so on(all P>0.05). Conclusions Apatinib combined with GEMOX regimen can significantly improve the short-term chemotherapy effect of advanced refractory ovarian cancer, control the progression of disease, prolong the survival time of patients, with controllable safety, which can be used as a second-line therapy for patients with advanced refractory ovarian cancer.