紫杉醇联合铂类新辅助化疗对上皮性卵巢癌的疗效和安全性研究

Study on the efficacy and safety of paclitaxel combined with platinum-based neoadjuvant chemotherapy in treating epithelial ovarian cancer

目的探讨紫杉醇联合铂类新辅助化疗对上皮性卵巢癌的疗效和安全性。方法回顾性分析2014年1月—2021年10月本院收治的上皮性卵巢癌患者62例的临床资料,根据是否接受新辅助化疗分为A组(新辅化结合减瘤术及术后辅助化疗,24例)和B组(初次减瘤术后辅助化疗,38例)两组。观察两组患者治疗后近期疗效和不良反应,以及血清肿瘤标志物糖类抗原125(CA125)、人附睾蛋白4(HE4)变化,并随访总生存期(OS)和无疾病进展生存期(PFS)。结果A组患者ORR为58.83%,DCR为79.17%;B组患者ORR为31.58%,DCR为63.16%。A组患者ORR高于B组(P<0.05),而两组DCR差异无统计学意义(P>0.05);A组患者治疗后血清CA125和HE4水平分为(204.65±56.22)U ml^(-1)、(121.28±20.34)pmol L^(-1)均低于B组的(449.46±68.01)U ml^(-1)、(258.87±22.40)pmol L^(-1)(均P<0.001);两组患者在胃肠道反应、骨髓抑制、肝肾功能损伤、心脏毒性、过敏反应、外周神经炎和其他毒副反应的发生率比较,差异均无统计学意义(P>0.05);A组中位PFS为24.0个月,高于B组的中位PFS(19.0个月)(P<0.05),A组中位OS为29个月,B组中位OS为27个月,两组差异无统计学意义(P>0.05)。结论增加紫杉醇联合铂类新辅助化疗治疗上皮性卵巢癌,客观有效率更高,能够降低肿瘤标志物水平,提高患者的无疾病进展时间,不良反应与术后应用相同。

Objective To investigate the efficacy and safety of paclitaxel combined with platinum neoadjuvant chemotherapy in epithelial ovarian cancer.Methods The clinical data of 62 patients suffered from epithelial ovarian cancer those were admitted to Wuhu second people's hospital from January 2014 to October 2021 were retrospectively analyzed.According to whether they received neoadjuvant chemotherapy,they were divided into group A(neoadjuvant chemotherapy combined with tumor reduction and postoperative adjuvant chemotherapy,24 cases)and group B(adjuvant chemotherapy after primary tumor reduction,38 cases).The short-term efficacy and adverse reactions of the two groups after treatment were observed,as well as the changes of serum tumor markers carbohydrate antigen 125(CA125)and human epididymis protein 4(HE4).The overall survival(OS)and progression-free survival(PFS)were followed up.Results ORR was 58.83%and DCR was 79.17%in group A;ORR and DCR in group B were 31.58%and 63.16%,respectively.ORR in group A was higher than that in group B(P<0.05),while there was no significant difference in DCR between the two groups(P>0.05).After treatment,the serum levels of CA125 and HE4 in group A were(204.65±56.22)U mL^(-1) and(121.28±20.34)pmol L^(-1),which were lower than(449.46±68.01)U mL^(-1) and(158.87±22.40)pmol L^(-1) in group B(all P<0.001).There were no significant difference in the incidence of gastrointestinal reactions,bone marrow suppression,liver and kidney dysfunction,cardiac toxicity,allergic reactions,peripheral neuritis and other adversereactions between the two groups(P>0.05).The median PFS in group A was 24.0 months,which was higher than 19.0 months in group B(P<0.05).The median OS of group A was 29 months,and that of group B was 27 months,with no significant difference between the two groups(P>0.05).Conclusions Adding paclitaxel combined with platinum-based neoadjuvant chemotherapy in the treatment of epithelial ovarian cancer has a higher objective effective rate,which can reduce the level of tumor markers and increase the time of disease-free progression of patients,with the same adverse reactions as postoperative application.