目的 探讨贝伐珠单抗联合TC(紫杉醇/卡铂)方案治疗晚期复发性卵巢癌患者的效果。方法 选取2017年11月至2022年11月汉中市中心医院收治的92例复发性晚期卵巢癌患者进行随机对照试验，采用随机数字表法将其分为对照组和观察组，各46例。对照组年龄(52。34±8。45)岁，国际妇产科联盟(International Federation of Gynecology and Obstetrics，IFGO)分期Ⅲ期24例、Ⅳ期22例。观察组年龄(53。21±9。67)岁，FIGO分期Ⅲ期23例、Ⅳ期23例。对照组采用TC方案治疗，观察组在对照组基础上加用贝伐珠单抗治疗;两组均治疗6个周期，约18周。对比两组患者治疗后临床疗效、肿瘤血清标志物[糖类抗原125(carbohydrate antigen 125，CA125)、人附睾蛋白4(human epididymis protein 4，HE4)、糖类抗原 199(carbohydrate antigen 199，CA199)、血管内皮生长因子(vascular endothelial growth factor，VEGF)]水平、治疗后1年生存率、生存质量[采用卡氏功能状态量表(Kamofsky Performance Status Scale，KPS)]评分和不良反应发生情况。采用t检验、x2检验。结果 治疗6个周期后，观察组疾病缓解率为78。26％(36/46)，高于对照组的54。35％(25/46)(x2=7。771，P=0。005);观察组CA125、HE4、CA199和VEGF水平均低于对照组(均P＜0。05);观察组治疗后1年生存率为 73。91％(34/46)，高于对照组 46。65％(21/46)(x2=7。640，P=0。006);观察组 KPS 评分为(72。52±8。13)分，高于对照组的(64。60±7。58)分(t=4。832，P＜0。001);两组主要不良反应为骨髓抑制、消化道反应和肝肾损伤;观察组与对照组各不良反应发生率相比，差异均无统计学意义(均P＞0。05)。结论 贝伐珠单抗联合TC方案治疗复发性晚期卵巢癌患者临床效果较好，可提高患者1年生存率和生活质量，降低肿瘤血清标志物水平，且不良反应可控。
Bevacizumab combined with TC regimen in treatment of patients with advanced recurrent ovarian cancer
Objective To explore the effect of bevacizumab combined with the TC(paclitaxel/carboplatin)regimen in the treatment of patients with advanced recurrent ovarian cancer.Methods Ninety-two patients with recurrent advanced ovarian cancer treated at Hanzhong Central Hospital from November 2017 to November 2022 were selected for the randomized controlled trial,and were divided into a control group and an observation group by the random number table method,with 46 cases in each group.The control group were(52.34±8.45)years old;there were 24 cases of stage Ⅲ and 22 cases of stage Ⅳ of International Federation of Gynecology and Obstetrics(IFGO).The observation group were(53.21±9.67)years old;there were 23 cases of stage Ⅲ and 23 cases of stage Ⅳ of FIGO.The control group were treated by the TC regimen;in addition,the observation group took bevacizumab.The clinical efficacies,serum levels of tumor markers[carbohydrate antigen 125(CA125),human epididymis protein 4(HE4),carbohydrate antigen 199(CA199),and vascular endothelial growth factor(VEGF)],one-year survival rates,and quality of life[evaluated by Karnofsky Performance Status(KPS)]after the treatment,and adverse reactions were compared between the two groups.t and x2 tests were applied.Results After six cycles of treatment,the disease remission rate in the observation group was higher than that in the control group[78.26％(36/46)vs.54.35％(25/46);x2=7.771,P=0.005];the levels of CA125,HE4,CA199,and VEGF in the observation group were lower than those in the control group(all P＜0.05).The one-year survival rate after the treatment in the observation group was higher than that in the control group[73.91％(34/46)vs.46.65％(21/46);x2=7.640,P=0.006].The score of KPS in the observation group was higher than that in the control group[(72.52±8.13)vs.(64.60±7.58);t=4.832,P＜0.001].The main adverse reactions in both groups were bone marrow suppression,gastrointestinal reactions,and hepatic and renal damage;there were no statistical differences in the incidences of these reactions between the two groups(all P＞0.05).Conclusion Bevacizumab combined with the TC regimen in the treatment of patients with recurrent advanced ovarian cancer has good clinical efficacy,can improve their one-year survival rate and quality of life and reduce the serum levels of tumor markers,and has controllable adverse reactions.
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