晚期卵巢癌患者术后一线化疗结束后应用奥拉帕利维持治疗的临床效果观察

Clinical effect of olaparil maintenance therapy after first-line chemotherapy for advanced ovarian cancer patients

目的探讨晚期卵巢癌患者术后接受一线化疗结束后应用奥拉帕利维持治疗的效果,为国内晚期卵巢癌患者术后一线化疗结束后维持治疗提供坚实的理论依据。方法回顾性收集郑州大学第一附属医院妇科2018年5月至2021年11月收治的晚期卵巢癌患者83例,根据患者在一线化疗结束后8周内是否开始口服奥拉帕利维持治疗分为维持治疗组(n=41)和对照组(n=42),比较观察2组患者的中位疾病无进展生存时间(PFS)和不良反应。结果至随访数据收集截止时间前,以奥拉帕利作为维持治疗的维持治疗组患者中位PFS为17个月,长于对照组患者的12个月,差异有统计学意义(χ^(2)=44.431,P<0.001)。维持治疗2组中乳腺癌易感基因(BRCA)基因无突变患者中位PFS为13个月,长于对照2组中BRCA基因无突变患者的9个月,差异有统计学意义(χ^(2)=18.083,P<0.001)。随访期间应用奥拉帕利患者中仅有3例因不良反应减量或中断,未发现因不良反应停止用药患者和治疗性死亡患者。结论无论患者BRCA基因是否突变,晚期卵巢癌经一线治疗结束后以奥拉帕利维持治疗效果显著,且安全性较高,在维持治疗晚期卵巢癌方面具有很高的临床应用价值。

Objective To investigate the effect of maintenance therapy with olaparil after first-line chemotherapy for advanced ovarian cancer patients,and to provide a solid theoretical basis for maintenance therapy after first-line chemotherapy for advanced ovarian cancer patients in China.Methods Eighty-three patients with advanced ovarian cancer treated in the Department of Gynecology of the First Affiliated Hospital of Zhengzhou University from May 2018 to November 2021 were retrospectively collected.The patients were divided into the maintenance treatment group(n=41)and the control group(n=42)according to whether oral maintenance therapy of olaparil was started within 8 weeks after the end of first-line chemotherapy.The length of progression free survival(PFS)and the occurrence of adverse reactions in the two groups were compared and analyzed.Results Up to the cut-off time of follow-up data collection,the PFS of patients in the maintenance treatment group was 17 months,and was 12 months in the control group(χ^(2)=44.431,P<0.001).The PFS of patients without breast cancer susceptibility gene(BRCA)gene mutation in the second maintenance treatment group was 13 months,and was 9 months in the second control group(χ^(2)=18.083,P<0.001).During the follow-up period,only 3 patients treated with oraparil were reduced or interrupted due to adverse reactions,and no patients who stopped using olaparil due to adverse reactions or died of treatment were found.Conclusion Regardless of BRCA gene mutation status of patients with advanced ovarian cancer,olaparil maintenance therapy after first-line chemotherapy has a significant effect,and there are acceptable and controllable treatment-related adverse reactions,which has high clinical application value in the maintenance treatment of advanced ovarian cancer.