甲磺酸阿帕替尼联合依托泊苷治疗铂耐药复发卵巢癌的疗效及安全性

Efficacy and Safety of Apatinib Mesylate Combined with Etoposide in the Treatment of Platinum-Resistant Recurrent Ovarian Cancer

目的:探讨甲磺酸阿帕替尼联合依托泊苷治疗铂耐药复发卵巢癌的疗效及安全性。方法:前瞻性选取2018年1月至2021年12月该院收治的铂耐药复发卵巢癌患者115例为研究对象,按随机数字表法分为治疗1组38例、治疗2组38例和治疗3组39例。治疗1组患者口服甲磺酸阿帕替尼,治疗2组患者口服依托泊苷,治疗3组患者给予甲磺酸阿帕替尼联合依托泊苷治疗。比较三组患者治疗6个周期的疗效、CA125水平及不良反应发生情况,并随访记录患者的无进展生存期。结果:等机秩和检验结果显示,三组患者疗效比较的差异有统计学意义(χ^(2)=15.789,P<0.05),且治疗3组患者的临床获益率、总缓解率明显高于治疗1组、治疗2组(χ^(2)分别为7.546、11.871,P<0.05)。重复测量方差分析结果显示,三组患者CA125水平的时点、组间、时点与组间的交互作用比较,差异均有统计学意义(P<0.05);两两比较结果显示,三组患者治疗前CA125水平的组间差异无统计学意义(P>0.05),治疗3组患者治疗后的CA125水平低于治疗2组、治疗1组,差异有统计学意义(P<0.05);三组患者治疗后的CA125水平与治疗前同组相比明显降低,差异均有统计学意义(P<0.05)。三组患者不良反应发生率比较,差异无统计学意义(P>0.05)。Kaplan-Meier生存分析结果显示,治疗3组患者的无进展生存期明显长于治疗2组、治疗1组,差异均有统计学意义(χ^(2)=18.552,P<0.05)。结论:甲磺酸阿帕替尼联合依托泊苷用于铂耐药复发卵巢癌的疗效更好,可有效降低CA125水平,不增加不良反应发生风险,具有安全性。

OBJECTIVE:To probe into the efficacy and safety of apatinib mesylate combined with etoposide in the treatment of platinum-resistant recurrent ovarian cancer.METHODS:A total of 115 patients with platinum-resistant recurrent ovarian cancer admitted into the hospital from Jan.2018 to Dec.2021 were prospectively extracted as the research objects.According to the random number table method,all patients were divided into the treatment group 1(n=38),treatment group 2(n=38)and treatment group 3(n=39).Treatment group 1 was treated with oral apatinib mesylate,treatment group 2 was given oral etoposide,and treatment group 3 received apatinib mesylate combined with etoposide.The efficacy,CA125 level and adverse drug reactions of three groups were compared for 6 cycles of treatment,and the progression-free survival time was recorded during follow-up.RESULTS:The isochronous rank sum test showed that there was statistically significant difference in the efficacy of three groups(χ^(2)=15.789,P<0.05),and the CBR and ORR of treatment group 3 were significantly higher than those of the treatment group 1 and the treatment group 2(χ^(2) were 7.546 and 11.871 respectively,P<0.05).Repeated-measures analysis of variance showed that there were statistically significant differences in the point-in-time,between-group,and between-group interactions of CA125 levels among three groups(P<0.05).Results of the two comparisons showed that there was no statistically significant difference in CA125 levels among three groups before treatment(P>0.05),and the CA125 level in treatment group 3 after treatment was lower than that in treatment group 2 and treatment group 1,with statistically significant differences(P<0.05).The CA125 levels of three groups after treatment were significantly lower than those of the same group before treatment,and the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse drug reactions among three groups(P>0.05).Kaplan-Meier survival analysis showed that the progression-free survival time of treatment group 3 was longer than that of treatment group 2 and treatment group 1,the difference was statistically significant(χ^(2)=18.552,P<0.05).CONCLUSIONS:Apatinib mesylate combined with etoposide has better efficacy in the treatment of platinum-resistant recurrent ovarian cancer,which can effectively reduce the CA125 levels,without increasing the risk of adverse drug reactions.