重组人血管内皮抑制素联合静脉化疗和腹腔热灌注化疗治疗晚期卵巢癌的临床研究

Clinical study of recombinant human endostatin combined with intravenous chemotherapy and intraperitoneal hyperthermic perfusion chemotherapy for advanced ovarian cancer

目的观察重组人血管内皮抑制素（恩度）联合静脉化疗和腹腔热灌注化疗治疗晚期卵巢癌的临床疗效。方法将61例晚期卵巢癌患者按照随机数字表法分为治疗组（31例）和对照组（30例），治疗组给予恩度＋TP方案（紫杉醇静脉化疗＋顺铂腹腔热灌注化疗）；对照组给予恩度＋TP方案（紫杉醇静脉化疗＋顺铂静脉化疗）。观察两组患者的复发率、生存率、生活质量改善情况及不良反应。结果治疗组患者中64．5％（20／31）的生活质量得到改善，显著高于对照组的33．3％（10／30）（X^2=5．931，P=0．015）。治疗组患者的1、2年复发率显著低于对照组[17．2％（5／29）比41．4％（12／29）和34．5％（10／29）比62．1％（18／29），P=0．043、0．036]。治疗组患者的1、2年生存率显著高于对照组[93．1％（27／29）比72．4％（21／29）和79．3％（23，29）比51．7％（15／29），P=0．037、0．027]。治疗组患者恶心、呕吐的发生率为67．7％（21，31），对照组为93．3％（28／30），两组比较差异有统计学意义（P=0．012）。两组患者骨髓抑制、脱发及肝肾功能损害等的发生率比较差异无统计学意义（P〉0．05）。结论恩度联合静脉化疗和腹腔热灌注化疗治疗晚期卵巢癌安全、有效，可以提高患者的生活质量，降低复发率，延长生存期。

Objective To observe the clinical efficacy of recombinant human endostatin （endostar） combined with intravenous chemotherapy and intraperitoneal hyperthermic perfusion chemotherapy for advanced ovarian cancer （AOC）. Methods Sixty-one patients with AOC were divided into treatment group （31 cases） and control group （30 cases） by table of random digit. The treatment group was given endostar ＋ TP project （paclitaxel intravenous chemotherapy ＋ cisplatin intraperitoneal hyperthermic perfusion chemotherapy）. The control group was given endostar ＋ TP project （paclitaxel and cisplatin intravenous chemotherapy ）. The recurrence rate, survival rate, improvement of quality of life （QOL） and drug side effects were observed in two groups. Results The improvement rate of QOL in treatment group was significantly higher than that in control group [64.5%（20/31 ） vs. 33.3%（ 10/30）, X2 = 5.931 ,P = 0.015 ]. The 1-year and 2-year recurrence rate in treatment group were significantly lower than those in control group [ 17.2%（5/29） vs. 41.4%（12/29）, 34.5%（10/29） vs. 62.1%（18/29） ,P = 0.043 and 0.036 ]. The 1-year and 2-year survival rate in treatment group were significantly higher than those in control group [93.1% （27/29） vs. 72.4% （ 21/29 ）, 79.3% （ 23/29 ） vs. 51.7% （ 15/29 ）, P = 0.037 and 0.027 ]. The incidence of nausea and vomiting in treatment group was significantly lower than that in control group [67.7%（21/31 ） vs. 93.3%（28/30）,P = 0.0121,there was no significant differences in bone marrow suppression,hair loss and liver and renal injury incidence between two groups （P 〉 0.05）. Conclusion Endostar combined with intravenous chemotherapy and intraperitoneal hyperthermic perfusion chemotherapy for AOC is safe and effective, and can improve patients＇ QOL, reduce the rate of recurrence and prolong survival time.