多西他赛联合卡铂与紫杉醇联合顺铂治疗晚期卵巢癌的疗效和安全性比较

Comparison of Efficacy and Safety of Docetaxel Combined with Carboplatin and Paclitaxel and Cisplatin in the Treatment of Advanced Ovarian Cancer

目的:比较多西他赛联合卡铂与紫杉醇联合顺铂治疗晚期卵巢癌的疗效、安全性及血管内皮生长因子(VEGF)和基质金属蛋白酶(MMP)-2水平。方法:120例晚期卵巢癌患者随机分为多西他赛联合卡铂组(60例)和紫杉醇联合顺铂组(60例)。多西他赛联合卡铂组患者给予多西他赛注射液70 mg/m^2,静脉滴注1 h,d_1;卡铂注射液50 mg/m^2,静脉滴注1 h,d_2。紫杉醇联合顺铂组患者给予紫杉醇注射液135 mg/m^2,持续静脉滴注24 h,d_1;注射用顺铂30 mg/m^2,静脉滴注,d_3,适度水化利尿;后给予紫杉醇注射液60 mg/m^2(上限为2.0 m^2)腹腔灌注,d_8。两组均以3周为1个周期,连续治疗6个周期。比较两组患者的临床疗效,治疗前后VEGF、MMP-2水平,无进展生存期,治疗后2年内病死率及不良反应发生情况。结果:两组患者客观有效率、疾病控制率、2年内病死率、不良反应发生率比较,差异均无统计学意义(P>0.05)。多西他赛联合卡铂组无进展生存期显著长于紫杉醇联合顺铂组,差异有统计学意义(P<0.05)。治疗前,两组患者VEGF、MMP-2水平比较,差异均无统计学意义(P>0.05)。治疗后,两组患者VEGF、MMP-2水平均显著低于同组治疗前,且多西他赛联合卡铂组不同时间点VEGF及治疗后第4周、第8周、第12周MMP-2水平低于紫杉醇联合顺铂组,差异均有统计学意义(P<0.05)。结论:多西他赛联合卡铂与紫杉醇联合顺铂治疗晚期卵巢癌的疗效、安全性均相当,但多西他赛联合卡铂在降低VEGF、MMP-2水平,改善无进展生存期方面优于紫杉醇联合顺铂。

OBJECTIVE:To compare the efficacy,safety,vascular endothelial growth factor(VEGF)and matrix metalloproteinase-2(MMP-2)of docetaxel combined with carboplatin and paclitaxel combined with cisplatin(DDP)in the treatment of advancedovarian cancer. METHODS:120 patients with advanced ovarian cancer were randomly divided into docetaxel combinedwith carboplatin group(60 cases)and paclitaxel combined with DDP group(60 cases). Docetaxel combined with carboplatin groupreceived 70 mg/m2 Docetaxel injection,intravenous infusion of 1 h,d1;50 mg/m2 carboplatin injection,intravenous infusion of 1h,d2. Paclitaxel combined with DDP group received 135 mg/m2 Paclitaxel injection,intravenous infusion of 24 h,d1;30 mg/m2DDP for injection,intravenous infusion,d3;60 mg/m2 Paclitaxel injection(a maximum of 2.0 m2)by intraperitoneal infusion,d8.3-week was regarded as 1 treatment course,and it lasted 6 courses. Clinical efficacy,VEGF,MMP-2,progression-free survival,overall survival before and after treatment,mortality rate within 2 years of treatment and the incidence of adverse reactions in 2groups were compared. RESULTS:There were no significant differences in the objective response rate,disease control rate,mortalityrate,incidence of adverse reactions between 2 groups(P>0.05). The progression-free survival in docetaxel combined with carboplatingroup was significantly longer than paclitaxel combined with DDP group,the difference was statistically significant(P<0.05). Before treatment,there were no significant differences in VEGF and MMP-2 level between 2 groups(P>0.05). After treatment,VEGF and MMP-2 level in 2 groups were significantly lower than before,and VEGF at different time points and MMP-2level after 4 weeks,8 weeks and 12 weeks of treatment in docetaxel combined with carboplatin group were lower than paclitaxelcombined with DDP group,the differences were statistically significant(P<0.05). CONCLUSIONS:Docetaxel combined with carboplatinand paclitaxel combined with DDP shows similar efficacy and safety in the treatment of advanced ovarian cancer,butdocetaxel carboplatin combined with is superior to paclitaxel combined with DDP in reducing VEGF and MMP-2 and improving progression-free survival.