贝伐珠单抗联合化疗治疗晚期宫颈癌的疗效及对患者血清肿瘤标志物和免疫功能的影响

Efficacy of bevacizumab combined with chemotherapy in the treatment of advanced cervical cancer and its effect on serum tumor markers and immune function

目的:探讨贝伐珠单抗联合化疗治疗晚期宫颈癌的疗效及对患者血清肿瘤标志物和免疫功能的影响。方法:选取70例晚期宫颈癌患者为研究对象,按照治疗方式不同分为对照组(n=34)与观察组(n=36)。对照组患者予以化疗治疗;观察组予以贝伐珠单抗联合化疗治疗,两组患者均以21 d为1个周期,连续治疗6个周期;治疗结束后随访3年。比较两组患者近期疗效(客观缓解率及疾病控制率)、远期疗效[3年无进展生存(PFS)率及总生存(OS)率]、血清肿瘤标志物[鳞状细胞癌抗原(SCC)及细胞角蛋白19片段抗原(CYFRA21-1)]水平、T淋巴细胞亚群(CD4^(+)、CD8^(+)及CD4^(+)/CD8^(+))水平及不良反应发生情况。结果:治疗后,观察组患者客观缓解率高于对照组(72.22%vs.47.06%,P<0.05);3年PFS率高于对照组(53.7%vs.31.2%,P<0.05);血清SCC、CYFRA21-1水平低于对照组(P<0.05);CD4^(+)水平及CD4^(+)/CD8^(+)比值高于对照组(P<0.05)。两组患者疾病控制率、3年OS率及不良反应总发生率比较,差异无统计学意义(P>0.05)。结论:对于晚期宫颈癌患者,化疗联合贝伐珠单抗治疗可提高疗效,改善血清肿瘤标志物水平和免疫功能,且可获得更好的远期生存。

Objective:To investigate the effect of bevacizumab combined with chemotherapy in the treatment of advanced cervical cancer and its effect on serum tumor markers and immune function.Methods:70 patients with advanced cervical cancer were divided into control group(n=34)and observation group(n=36)according to different treatment methods.The two groups were treated with chemotherapy and bevacizumab combined with chemotherapy respectively,and they were treated continuously for 6 cycles,with 21 days as one cycle,followed up for 3 years after completion of treatment.The short-term efficacy(objective remission rate and disease control rate),long-term survival[3-year progression free survival(PFS)rate and overall survival(OS)rate],serum tumor markers[squamous cell carcinoma antigen(SCC),cytokeratin 19 fragment antigen(CYFRA21-1)],T lymphocyte subsets(CD4^(+),CD8^(+),CD4^(+)/CD8^(+))and adverse reactions were compared between the two groups.Results:Compared with the control group,the objective remission rate of the observation group was higher(72.22%vs.47.06%,P<0.05).The 3-year PFS rate of the observation group was 53.7%,which was higher than 31.2%of the control group(P<0.05).After treatment,compared with the control group,the levels of serum SCC,CYFRA21-1 in the observation group were lower(P<0.05),and the ratios of CD4^(+)and CD4^(+)/CD8^(+)were higher(P<0.05).There was no significant difference in disease control rate,3-year OS rate(67.0%vs.54.4%),and the incidence of adverse reactions between the two groups(P>0.05).Conclusion:For patients with advanced cervical cancer,chemotherapy combined with bevacizumab can improve the efficacy,effectively improve serum tumor markers and immune function,obtain better long-term survival.