白蛋白结合型紫杉醇联合卡铂治疗晚期复发性上皮卵巢癌的疗效及安全性分析

Efficacy and Prognosis of Albumin-bound Paclitaxel Combined with Carboplatin in the Treatment of Advanced Recurrent Epithelial Ovarian Cancer

目的探讨白蛋白结合型紫杉醇联合卡铂治疗晚期复发性上皮卵巢癌的疗效及安全性分析。方法收集晚期复发性上皮卵巢癌患者90例,采用随机数字表法进行分组,即对照组、治疗组,均45例。对照组患者采用紫杉醇(135 mg/m^(2))联合卡铂(400 mg/m^(2))进行治疗,治疗组采用白蛋白结合型紫杉醇(175 mg/m^(2))联合卡铂(400 mg/m^(2))治疗。对比两组患者临床疗效、血清肿瘤标志物(CA125、VEGF、MMP-2、HMGA2)水平、生命质量评分及安全性评估。结果治疗组临床总有效率(95.56%)、疾病控制率(86.67%)均显著高于对照组临床总有效率(75.56%)、疾病控制率(60.00%)(χ^(2)=7.652,P=0.006,χ^(2)=9.130,P=0.003)。治疗组CA125(157.21±33.43)U/ml、VEGF(131.61±58.72)pg/ml、MMP-2(153.22±61.47)ng/ml、HMGA2(142.48±41.51)mg/L水平,均显著低于对照组,差异均具有统计学意义(P<0.05)。治疗组肿瘤转移总发生率(13.33%)显著低于对照组(χ^(2)=5.031,P=0.025)。治疗组患者QLQ-OV28总分[(79.34±14.82)分]显著低于对照组(t=2.615,P=0.011)。两组患者在发热、血小板减少、中性粒细胞减少发生率方面比较,P>0.05,两组在乏力、过敏反应、肝功能损害、肾功能损害、消化系统反应、周围神经感觉异常发生率方面比较,P<0.05。结论白蛋白结合型紫杉醇联合卡铂治疗晚期复发性上皮卵巢癌患者,可显著改善患者临床疗效和生活质量,安全性较高,还可降低血清标志物水平,值得推广。

Objective To investigate the efficacy and safety of albumin-binding paclitaxel combined with carboplatin in the treatment of advanced recurrent epithelial ovarian cancer.Methods 90 patients with advanced recurrent epithelial ovarian cancer were collected and divided into 2 groups by random number table,the control group and the treatment group(45 cases).The control group was treated with paclitaxel(135 mg/m^(2))combined with carboplatin(400 mg/m^(2)),and treatment group was treated with albumin-binding paclitaxel(175 mg/m^(2))combined with carboplatin(400 mg/m^(2)).The clinical efficacy,serum tumor markers(CA125,VEGF,MMP-2,HMGA2)levels,life quality scores and safety evaluation were compared between the 2 groups.Results The total effective rate(95.56%)and disease control rate(86.67%)in treatment group were significantly higher than those in the control group(75.56%)and disease control rate(60.00%)(χ^(2)=7.652,P=0.006,χ^(2)=9.130,P=0.003).The levels of CA125(157.21±33.43)U/ml,VEGF(131.61±58.72)pg/ml,MMP-2(153.22±61.47)ng/ml and HMGA2(142.48±41.51)mg/L in the treatment group were significantly lower than those in the control group.All the differences were statistically significant(P<0.05).The total incidence of tumor metastasis in the treatment group(13.33%)was significantly lower than that in the control group(χ^(2)=5.031,P=0.025).The total score of QLQ-OV28[(79.34±14.82)]in treatment group was significantly lower than that in the control group(t=2.615,P=0.011).The incidence of fever,thrombocytopenia and neutropenia was compared between the 2 groups(P>0.05),and the incidence of fatigue,anaphylaxis,liver function impairment,kidney function impairment,digestive system reaction and peripheral nerve paresthesia was compared between the 2 groups(P<0.05).Conclusion Albumin-binding paclitaxel combined with carboplatin in the treatment of advanced recurrent epithelial ovarian cancer can significantly improve the clinical efficacy and quality of life of patients with high safety,but also can reduce the level of serum markers,worthy of promotion.