贝伐珠单抗联合顺铂和局部放疗治疗晚期子宫颈腺癌的疗效观察

Efficacy of bevacizumab combined with cisplatin chemotherapy and definitive radiotherapy in treatment of advanced cervical adenocarcinoma

目的研究贝伐珠单抗联合顺铂和局部放疗治疗晚期子宫颈腺癌的疗效及不良反应。方法随机收集骨盆有淋巴结转移、经组织病理学或细胞学证实为子宫颈腺癌患者75例,随机分为贝伐珠单抗联合放化疗(治疗组)40例、单纯放化疗组(对照组)35例。患者均行放疗,1周5天,放疗期间给予顺铂40 mg/m2,d1-2,共6个周期。治疗组在行放化疗同时给予贝伐珠单抗,每2周1次,10 mg/kg静脉输注,共3个周期。观察患者临床疗效、生活质量改善情况和不良反应。结果治疗组完全缓解0例,部分缓解22例,疾病稳定14例,疾病进展4例,临床有效率为55.0%。对照组完全缓解0例,部分缓解13例,疾病稳定17例,疾病进展5例,临床有效率37.1%。两组临床有效率比较差异有统计学意义(P=0.048)。两组患者治疗前Karnofsky评分比较差异无统计学意义(t=1.233,P>0.05),治疗后Karnofsky评分两组均增加(均P<0.05),治疗组评分高于对照组(t=14.337,P<0.05)。两组最常见不良反应是高血压,除高血压发生率比较差异有统计学意义(P=0.038)外,其余不良反应发生率比较差异均无统计学意义(均P>0.05)。结论贝伐珠单抗联合顺铂和局部放疗治疗晚期子宫颈腺癌显示一定疗效,有效提高患者的生活质量。

Objective To assess the efficacy and adverse reactions of bevacizumab combined with cisplatin chemotherapy and definitive radiotherapy in treatment of advanced cervical adenocarcinoma. Methods Seventy-five cervical adenocarcinoma patients with lymph node metastasis were randomly divided into bevacizumab combined with cisplatin chemotherapy and radiotherapy group（ combination group,n = 40）,and cisplatin chemotherapy and radiotherapy group（ control group,n = 35）. All patients were treated with radiotherapy for 5 days a week,and cisplatin 40 mg / m^2,d1-2,for a total of 6cycles. In addition,patients in combination group received intravenous infusion of 10 mg / kg bevacizumab once every two weeks for 3 cycles. The clinical curative effect,quality-of-life improvement and side effects were observed. Results There were 0 case of complete remission（ CR）,22 partial remission（ PR）,14 stable disease（ SD） and 4 progressive disease（ PD） in combination group with a response rate（ RR） of 55. 0%; while there were 0 case of CR,13 PR,17 SD,5 PD in control group with a RR of 37. 1%（ P = 0. 048）. There was no significant difference in Karnofsky performance scores（ KPS） before treatment between two groups（ t = 1. 233,P〉0. 05）,KPS scores were increased significantly after treatment in both groups（ P〈0. 05）,higher in combination group（ t = 14. 337,P〈0. 05）. Increased blood pressure was the most common side effect and had different incidence in two groups（ P = 0. 038）. There was no significant difference in incidence of other adverse reactions between two groups（ P〉0. 05）. Conclusion Bevacizumab combined cisplatin chemotherapy and radiotherapy is effective in treating advanced cervical adenocarcinoma with improved quality of life of patients.