贝伐珠单抗联合单药化疗治疗晚期宫颈腺癌的疗效研究

Effect of Bevacizumab Combined With Chemotherapy for Advanced Cervical Adenocarcinoma

目的观察贝伐珠单抗联合单药化疗治疗晚期宫颈腺癌的疗效及毒副作用。方法选择2010年11月—2013年7月就诊于辽宁医学院附属第一医院的宫颈癌患者9例,均为多线含铂方案化疗后复发进展的晚期宫颈腺癌。患者均经多线化疗进展后再用吉西他滨单药化疗2个周期,之后采用贝伐珠单抗（7.5 mg/kg,1次/3周）联合原化疗方案继续治疗。患者贝伐珠单抗联合化疗治疗3~6个周期,平均4个周期,每2个周期进行一次疗效评价。观察患者近期疗效、生活质量〔卡氏功能状态评分（KPS评分）〕、CA12-5水平、远期疗效及毒副作用。结果 9例患者客观缓解率（ORR）为7/9,其中部分缓解（PR）7例,疾病稳定（SD）2例。中位总生存时间（OS）为11.0个月,中位无进展生存时间（PFS）为6.2个月。联合化疗后KPS评分平均提高30分。9例患者CA12-5水平联合治疗前平均为312 U/ml,联合治疗2个周期后平均为138 U/ml,联合治疗4个周期后平均为46 U/ml,治疗4~9个月后CA12-5水平又逐渐增高。9例患者治疗中无明显毒副作用发生。结论靶向药物贝伐珠单抗在晚期宫颈腺癌治疗中显示了一定的疗效,用药安全,值得临床进一步研究。

Objective To observe the effects and adverse reactions of bevacizumab combined with chemotherapy in treatment of advanced cervical adenocarcinoma（ ACA）. Methods From November 2010 to July 2013,9 ACA patients admitted to this hospital,who had recurrence after having had multiline platinum-based chemotherapy,were given monotherapy with gemcitabine for 2 cycles,and then given bevacizumab combined with the primary chemotherapy,3-6 cycles,averagely 4cycles. Effect evaluation was performed every 2 cycles. The short-term effects,quality of life（ KPS score）,CA12-5 level,long-term effects and adverse reactions were observed. Results In 9 ACA patients,the objective remission rate（ ORR） was7 /9,including 7 cases of partial remission（ PR）,2 of stable disease（ SD）. The mean objective survival（ OS） was 11. 0months,mean progression-free survival（ PFS） was 6. 2 months. The KPS scores increased averagely by 30 points after combined chemotherapy. The mean CA12-5 level was 312 U / ml before combined chemotherapy,138 U / ml after 2 cycles of combined chemotherapy,46 U / ml after 4 cycles, and increased gradually after 4-9 month treatment. No obvious adverse reactions were noted during the treatment. Conclusion Bevacizumab has some effects on ACA and is safe,which is worthy of further studies.