安罗替尼与吉西他滨联合奥沙利铂方案治疗晚期难治性卵巢癌的临床效果及对患者相关指标的影响

Clinical effect of Rotinib and gemcitabine combined with oxaliplatin in the treatment of advanced refractory ovarian cancer and its influence on patient related indexes

目的分析安罗替尼与吉西他滨联合奥沙利铂(GEMOX)方案治疗晚期难治性卵巢癌的临床效果及对患者抑制血管内皮生长因子受体(VEGFR)、血小板衍生生长因子受体(PDGFR)、纤维母细胞生长因子受体(FGFR)及干细胞因子受体(c-Kit)的影响。方法选取2018年1月—2021年1月湖州市中心医院收治的晚期难治性卵巢癌患者81例为研究对象,根据治疗方案差异分为对照组(GEMOX方案,35例)和观察组(安罗替尼+GEMOX方案,46例)。3周为1个疗程,两组患者均治疗3个疗程后观察临床疗效、VEGFR、PDGFR、FGFR、c-Kit、肿瘤标志物、生存情况及毒性反应。结果观察组患者化疗后客观缓解率(ORR)、疾病控制率(DCR)均(39.13%、76.08%)明显高于对照组(17.14%、51.42%),差异均有统计学意义(χ^(2)=4.608、5.343,均P<0.05)。观察组患者化疗后VEGFR[(411.62±110.88)pg/ml]、PDGFR[(65.48±10.21)pg/ml]、FGFR DNA[(3.21±0.36)×10^(5)copies/μl]、c-Kit DNA[(2.13±0.54)×10^(5)copies/μl]、CA125[(43.94±7.84)U/L]及CEA[(6.94±1.34)ng/ml]表达水平均明显低于对照组[VEGFR(498.85±110.84)pg/ml、PDGFR(73.69±10.57)pg/ml、FGFR DNA(4.56±0.41)×10^(5)copies/μl、c-Kit DNA(3.21±0.60)×10^(5)copies/μl、CA125(88.76±7.69)U/L及CEA(11.64±1.58)ng/ml],差异均有统计学意义(t=3.507、3.530、15.742、8.497、26.771及14.469,均P<0.05)。观察组中位疾病无进展生存时间[(5.46±1.32)月]长于对照组[(3.85±1.71)月],6个月生存率(80.43%)、1年生存率(63.04%)高于对照组(60.00%,40.00%),差异均有统计学意义(t=4.784,χ^(2)=4.082、4.237,均P<0.05)。两组患者不良反应比较,差异均无统计学意义(均P>0.05)。结论安罗替尼联合GEMOX方案在晚期难治性卵巢癌中治疗效果可观,可抑制VEGFR、PDGFR、FGFR及c-Kit表达,降低肿瘤标志物水平,安全性较好。

Objective To analyze the clinical effect of anrotinib and gemcitabine combined with oxaliplatin(GEMOX)in the treatment of advanced refractory ovarian cancer and its inhibition of vascular endothelial growth factor receptor(VEGFR),platelet-derived growth factor receptor(PDCFR),fibroblast growth factor receptor(FGFR)and stem cell factor receptor(c-Kit).Methods A total of 81 patients with advanced refractory ovarian cancer admitted to Huzhou Central Hospital from January 2018 to January 2021 were selected as the study objects,and were divided into control group(GEMOX program,35 cases)and observation group(anrotinib+CEMOX program,46 cases)according to differences in treatment regiments.After 3 weeks of treatment,clinical efficacy,VECFR,PDGFR,FGFR,c-Kit,tumor mark ers,survival and toxicity were observed in the two groups.Results The objective remission rate(ORR)and disease control rate(DCR)after chemotherapy in the observation group(39.13%,76.08%)were higher than those in the control group(17.14%,51.42%),the differences were statistically significant(χ^(2)=4.608,5.343,all P<0.05).After chemotherapy in observation group[VECFR(411.62±110.88)pg/ml,PDCFR(65.48±10.21)pg/ml,FCFR DNA(3.21±0.36)×10^(5)copies/μl,c-Kit DNA(2.13±0.54)×10^(5)copies/μl,CA125(43.94±7.84)U/L,CEA(6.94±1.34)ng/ml were lower than the control group[VECFR(498.85±110.84)pg/ml,PDGFR(73.69±10.57)pg/ml,FCFR DNA(4.56±0.41)×10^(5)copies/μl,c-Kit DNA(3.21±0.60)×10^(5)copies/μl,CA125(88.76±7.69)U/L,CEA(11.64±1.58)ng/ml],the differences were statistically significant(t=3.207,3.530,15.742,8.497,26.771,14.469,all P<0.05).The median progression-free survival time of the observation group[(5.46±1.32)months]was longer than that of the control group[(3.85±1.71)months],and the 6-month survival rate(80.43%)and 1-year survival rate(63.04%)were higher than those of the control group group(60.00%,40.00%),the differences were statistically significant(t=4.784,χ^(2)=4.082,4.237,all P<0.05).There was no significant difference in toxicity between the two groups(P>0.05).Conclusion Antirotinib combined with CEMOX has a significant therapeutic effect in advanced refractory ovarian cancer,which can inhibit the expression of VEGFR,PDCFR,FCFR and c-Kit,and reduce the level of tumor markers,with good safety.