贝伐珠单抗联合紫杉醇+顺铂治疗宫颈癌术后复发/转移临床观察

Clinical Observation of Bevacizumab Combined with Paclitaxel+Cisplatin in the Treatment of Postoperative Recurrence/Metastasis of Cervical Cancer

目的探讨贝伐珠单抗联合紫杉醇+顺铂治疗宫颈癌术后复发/转移的临床疗效。方法选取医院2020年10月至2023年9月收治的宫颈癌术后复发/转移患者102例,随机分为观察组和对照组,各51例。两组患者均予紫杉醇注射液+顺铂注射液静脉滴注(紫杉醇滴注前12,6 h口服醋酸地塞米松片),观察组患者提前1 d予贝伐珠单抗注射液静脉滴注。两组治疗周期均为21 d,均治疗3个周期。结果观察组客观缓解率为92.16%,显著高于对照组的74.51%(P<0.05)。治疗后,两组患者的肿瘤标志物(肿瘤特异性生长因子、癌胚抗原、细胞角蛋白19片段21-1)、免疫功能指标[T细胞亚群CD_(3)^(+)、CD_(4)^(+)及免疫球蛋白(Ig)A、IgM)],肿瘤微环境指标(血管内皮生长因子、肿瘤坏死因子-α)水平均显著降低(P<0.05);欧洲癌症研究与治疗组织生活质量问卷和卡氏功能状态量表评分均显著升高(P<0.05);且观察组上述指标改善更显著或影响更小(P<0.05)。观察组不良反应发生率为11.76%,显著低于对照组的33.33%(P<0.05)。结论贝伐珠单抗联合紫杉醇+顺铂治疗宫颈癌术后复发/转移,能降低肿瘤标志物、肿瘤微环境指标水平,提高患者生存质量,且对免疫功能的不良影响更小。

Objective To investigate the clinical efficacy of bevacizumab combined with paclitaxel+cisplatin in the treatment of postoperative recurrence/metastasis of cervical cancer.Methods A total of 102 patients with postoperative recurrence/metastasis of cervical cancer admitted to the hospital from October 2020 to September 2023 were selected and randomly divided into the observation group and the control group,with 51 cases in each group.The patients in the two groups received intravenous drip of Paclitaxel Injection and Cisplatin Injection(Dexamethasone Acetate Tablets were orally administered 12 h and 6 h before intravenous drip of paclitaxel),while the patients in the observation group received intravenous drip of Bevacizumab Injection 1 d before giving paclitaxel and cisplatin.Both groups were treated for three cycles with 21 d as a cycle.Results The objective remission rate in the observation group was 92.16%,which was significantly higher than 74.51%in the control group(P<0.05).After treatment,the tumor markers[tumor specific growth factor(TSGF),carcinoembryonic antigen(CEA),cytokeratin 19 fragment 21-1(CYFRA21-1)],immune function-related indexes[T cell subsets CD_(3)^(+),CD_(4)^(+)and immunoglobulin(Ig)A,IgM)],tumor microenvironment-related indexes[vascular endothelial growth factor(VEGF),tumor necrosis factor-α(TNF-α)]levels in the two groups significantly decreased(P<0.05);the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire(EORTC QLQ-C30)and the Karnofsky Performance Status(KPS)scores significantly increased(P<0.05);the above indexes in the observation group were significantly better(P<0.05).The incidence of adverse reactions in the observation group was 11.76%,which was significantly lower than 33.33%in the control group(P<0.05).Conclusion Bevacizumab combined with paclitaxel+cisplatin can decrease tumor marker levels and tumor microenvironment-related index levels in patients with postoperative recurrence/metastasis of cervical cancer,improve the quality of life,and have less adverse effects on the immune function.