摘要
目的:观察重组人血管内皮抑制素恩度联合化学药物治疗晚期(IVb期)和复发转移性宫颈癌的近期疗效及不良反应。方法:收集中南大学湘雅二医院2016年12月至2018年12月收治的晚期和复发转移性宫颈癌患者44例,按随机数表法,随机分为实验组与对照组(n=22),对照组予以吉西他滨+顺铂(GP)或多西他赛+顺铂或(DP)治疗,实验组在对照组基础上加用恩度治疗,观察两组疗效与不良反应。结果:实验组客观缓解率(objective response rate,ORR)为42.9%,对照组为22.7%,两组差异无统计学意义(P=0.371)。实验组疾病控制率(disease control rate,DCR)为76.2%,对照组为68.2%,两组差异无统计学意义(P=0.558)。亚组分析发现DP或GP联合恩度比不联合恩度在ORR上提高近1倍(分别为50.0%vs 27.3%与36.4%vs 18.2%),但差异无统计学意义(P>0.05);DP或GP联合恩度比不联合恩度在DCR上无明显改善(分别为80.0%vs 72.7%与72.7%vs 63.6%,P>0.05)。实验组与对照组中位无进展生存时间分别为7.2个月和5.1个月,两组差异有统计学意义(P=0.036)。两组主要3~4级不良反应为骨髓抑制,实验组和对照组3~4级中性粒细胞减少发生率分别为54.5%与50.0%,差异无统计学意义(P=0.763)。实验组心血管不良反应发生率高于对照组(13.6%vs 0),但两组差异无统计学意义(P=0.233)。结论:恩度联合化学药物治疗较单纯化学药物治疗延长了患者中位无进展生存时间,ORR也有获益,且不增加不良反应。
Objective:To observe the efficacy and adverse reactions of the combination of endostar with chemotherapy in the treatment of advanced(IVb)and recurrent metastatic cervical cancer.Methods:Forty-four patients with recurrent and metastatic cervical cancer,who were admitted to the Second Xiangya Hospital,Central South University from December 2016 to December 2018 were randomly divided into an experimental group and a control group(22 cases in each group).The control group was given gemcitabine plus cisplatin(GP)or docetaxel plus cisplatin(DP)treatment,the experimental group was treated with endostar on the basis of the control group.Results:The objective response rate(ORR)was 42.9%in the experimental group and 22.7%in the control group.There was no significant difference between the 2 groups(P=0.371).The disease control rate(DCR)was 76.2%in the experimental group and 68.2%in the control group.There was no significant difference between the 2 groups(P=0.558).The effect of combined endostar was doubled compared with the effect of non-combination(50.0%vs 27.3%and 36.4%vs 18.2%),but there was no significant difference(P>0.05).Subgroup analysis found no significant difference in DP/GP with or without endostar on DCR(80.0%vs 72.7%,72.7%vs 63.6%,P>0.05,respectively).The median progressionfree survival of the experimental group and the control group were 7.2 months and 5.1 months,respectively,and the difference was statistically significant(P=0.036).The 2 groups mainly showed that the 3−4 adverse reaction was myelosuppression.The incidence of neutropenia of grade Ⅲ-Ⅳ in the experimental group and the control group were 54.5%and 50.0%,respectively,and there was no statistical difference(P>0.05).The incidence of cardiovascular toxicity was higher in the experimental group than that in the control group(13.6%vs 0),but there was no significant difference between the 2 groups(P=0.233).Conclusion:Compared with chemotherapy alone,endostar combined with chemotherapy can prolong the median progression-free survival,with higher ORR and similar adverse reactions.
作者
郭峰
陈采枝
梁叶
马淑云
邹文
GUO Feng;CHEN Caizhi;LIANG Ye;MA Shuyun;ZOU Wen(Department of Oncology,Second Xiangya Hospital,Central South University,Changsha 410011,China)
出处
《中南大学学报（医学版）》
CAS
CSCD
北大核心
2020年第12期1412-1418,共7页
Journal of Central South University ：Medical Science
关键词
重组人血管内皮抑素
恩度
宫颈癌
复发
转移
recombinant human endostatin
endostar
cervical cancer
recurrence
metastasis
