安罗替尼联合依托泊苷二线治疗铂类耐药型晚期卵巢癌的临床研究

Anlotinib combined with etoposide in the treatment of platinum-resistant advanced ovarian cancer

目的:探讨安罗替尼联合依托泊苷二线治疗铂类耐药型晚期卵巢癌的临床效果。方法:选取2018-06-01~2019-08-01我院收治的铂类耐药型晚期卵巢癌患者64例,采用随机数字表法分为对照组(n=32)和观察组(n=32)。对照组给予依托泊苷治疗,观察组在对照组基础上加用安罗替尼。治疗6周后,比较两组近期疗效、远期生存率、血清血管内皮生长因子水平、不良反应发生情况、卡式功能状态评分。结果:观察组客观缓解率和疾病控制率分别为68.75%和78.13%,显著高于对照组的40.63%和53.13%,差异有统计学意义(P<0.05)。随访30个月,两组死亡38例,其中对照组23例,观察组15例。对照组和观察组1年生存率分别为46.88%(15/32)、71.88%(23/32);2年生存率分别为34.38%(11/32)、59.38%(19/32)。两组1年生存率和2年生存率比较,差异有统计学意义(P<0.05)。治疗6周后观察组血清血管内皮生长因子水平为(180.36±29.14)pg/ml,显著低于对照组的(241.28±32.57)pg/ml,差异有统计学意义(P<0.05)。两组用药期间均有恶心呕吐、胃肠胀气、腹泻、手足综合征、高血压及白细胞减少等不良反应,但两组不良反应发生率比较,差异无统计学意义(P>0.05)。观察组治疗后卡式功能状态评分为(82.15±9.57)分,显著高于对照组的(75.16±9.14)分,差异有统计学意义(P<0.05)。结论:安罗替尼联合依托泊苷二线治疗铂类耐药型晚期卵巢癌较单用依托泊苷预后更好,考虑与联合用药抑制血管内皮生长因子表达水平有关,且不增加毒副作用。

Objective:To investigate the clinical efficacy of anlotinib combined with etoposide in the treatment of platinum-resistant advanced ovarian cancer.Methods:Sixty-four patients with platinum-resistant advanced ovarian cancer in our hospital from June 2018 to August 2019 were selected and they were randomly divided into control group(n=32)and observation group(n=32).The control group was treated with etoposide,while the observation group was treated with anlotinib on the basis of the control group.The short-term efficacy,long-term survival rate,the level of vascular endothelial growth factor(VEGF),adverse reactions and Karnosky performance status(KPS)were compared between the two groups.Results:After treatment for 6 weeks,the objective response rate and disease control rate of the observation group were 68.75%and 78.13%,respectively.They were significantly higher than those of the control group 40.63%and 53.13%(P<0.05).At the end of follow-up for 30 months,38 cases died in the two groups,including 23 cases in the control group and 15 cases in the observation group.The 1-year survival rate of the control group and the observation group were 46.88%(15/32)and 71.88%(23/32),respectively.The 2-year survival rate were 34.38%(11/32)and 59.38%(19/32),respectively.There was significant difference in 1-year survival rate and 2-year survival rate between the two groups(P<0.05).At 6 weeks after treatment,the level of serum VEGF of the observation group was(180.36±29.14)pg/ml,which was significantly lower than that of the control group(241.28±32.57)pg/ml(P<0.05).Adverse reactions of nausea and vomiting,flatulence,diarrhea,hand and foot syndrome,hypertension and leukopenia occurred in both groups.There was no significant difference in the incidence of adverse reactions(P>0.05).After treatment,the KPS score in the observation group was(82.15±9.57),which was significantly higher than that in the control group(75.16±9.14)(P<0.05).Conclusion:Anlotinib combined with etoposide has a better prognosis than etoposide in the treatment of platinum-resistant advanced ovarian cancer,it is associated with the inhibition of VEGF expression by combination therapy,and it does not increase the toxic side effects.