| Objective:To evaluate the clinical efficacy and untoward reactions of Apatinib combined with albumin paclitaxel in the treatment of platinum-resistant and refractory ovarian cancer.Methods:Cases of platinum-resistant or refractory ovarian cancer from March 2016 to January 2020 in Shanxi Provincial Cancer Hospital were selected.Randomly divided into 3 groups,a): control group-1,albumin paclitaxel-only chemotherapy group(24cases);b): control group-2,paclitaxel + apatinib combined group(24 cases);c):experimental Group,albumin paclitaxel + apatinib combined group(24 cases).According to the evaluation criteria of solid tumor efficacy,comparing the objective response rate(ORR)and disease control rate(DCR)of the control group and the experimental group,and the tumor markers(CA125,CA199,HE4,CEA)before and after therapy,untoward reactions in patients and anxiety scores were compared.Results:1.General data analysisThe results of the control group-1 and the experimental group,and the results of the control group-2 and the experimental group were not different in general clinical data(age,stage,neoadjuvant chemotherapy,preoperative serum albumin level,number of operations,pathological type,tumor differentiation degree,and ascites).There is statistical significance(P>0.05).2.Clinical efficacyAccording to the evaluation criteria of solid tumors,in the albumin paclitaxel chemotherapy group,there were no CR patients,PR accounted for 8 cases(33.3%),SD accounted for 9 cases(37.5%),PD accounted for 7 cases(29.2%);paclitaxel+apatinib combination group:CR patients accounted for 1 case(4.2%),PR accounted for 9 cases(37.5%),SD accounted for 8 cases(33.3%),PD accounted for 6 cases(25.0%);albumin paclitaxel + apatinib combination group:CR patients accounted for3 cases(12.5%),PR accounted for 14 cases(58.3%),SD accounted for 6 cases(25.0%),and PD accounted for 1 case(4.2%).Comparing with the ORR results of the control group 1 and the experimental group,there was difference(70.83% VS 33.33%,P=0.009<0.01);Comparing with the DCR of the control group 1 and the experimental group,It was statistically significant(95.83% VS 70.83%,P=0.020<0.05);Comparing with the ORR results of the control group 2 and the experimental group,there was difference(70.83% VS 41.67%,P=0.042<0.05);Comparing with the DCR of the control group 2 and the experimental group,there was no difference(95.83% VS75.00%,P=0.102>0.05).3.Comparison of serum tumor marker levels before and after treatmentThe results of serum tumor markers before treatment in the control group 1,control group 2 and experimental group were: 191.35±21.13,203.78±22.03,200.91±19.36(CA125),136.12±18.49,151.78±15.72,108.34±14.90(HE4),respectively,40.30±6.95,33.24±7.74,37.16±8.44(CA199),1.45±0.06,1.40±0.38,1.26±0.34(CEA);control group-1,control group-2,experimental group serum tumor marker results after treatment They are 70.45±9.36,74.32±8.08,32.05±6.23(CA125),91.42±9.65,88.34±9.40,59.05±6.54(HE4),27.44±5.55,32.33±7.66,21.12±4.69(CA199),1.23±0.35,0.89±0.11,0.68±0.17(CEA).There was no difference in the levels of tumor markers(CA125,HE4,CA199 and CEA)between the experimental group and the control group before treatment(P>0.05);The levels of CA125,HE4,and CEA in the experimental group after treatment were lower than the control group-1,and the difference was statistically significant(P < 0.05).The level of CA199 was also lower than that in the control group-1,but between the groups there was no difference(P>0.05);the experimental group had lower levels of CA125,HE4,and CA199 after treatment than the control group-2,and the difference was statistically significant(P<0.05),and the level of CEA was also lower than that of the control group-2.But there was no difference between the groups(P>0.05).4.Adverse reactionsThe morbidity of hypertension in the experimental group was 54.17%,which was higher than 25.00% in the control group-1.There was difference between the two data(P=0.039<0.05);the morbidity of dermatosis of hand and foot in the experimental group higher than the control group-1(75.00% VS 29.17%,P=0.001<0.01);In the experimental group and the control group-1,incidence of bone marrow suppression(leukopenia,hemoglobin reduction,thrombocytopenia)was no difference(P>0.05);The overall morbidity of untoward reactions in the experimental group(52.92%)was higher than that of the control group-1(44.17%),and the difference was not statistically significant(P=0.055>0.05).The untoward reactionss in the experimental group and the control group-2 were mainly neurotoxicity,leukopenia,and dermatosis of hand and foot.The incidence of leukopenia in the control group-2 was higher than that in the experimental group(P=0.033<0.05);the incidence of neurotoxicity and hand-foot skin lesions was not statistically significant(P>0.05).The incidences of hypertension,proteinuria,and gastrointestinal reactions in the control group-2 were higher than those in the experimental group,and there was no statistical difference between the groups(P>0.05).The overall incidence of untoward reactions in the control group-2 was higher than that in the experimental group(62.50% VS 52.92%,P=0.034<0.05).5.Comparison of SAS scores before and after treatmentThe SAS scores before treatment of the control group-1 and the control group-2were not statistically different from the experimental group(P>0.05).The SAS score after treatment of the experimental group was lower than the control group-2(P<0.05),and higher than the control group-1(P>0.05).Conclusions:Compared with pure albumin paclitaxel chemotherapy and apatinib combined with traditional paclitaxel,in the treatment of platinum-resistant and refractory ovarian cancer,the combination of apatinib and albumin paclitaxel can well control the development of the disease and improve the clinical The curative effect and certain safety provide new ideas for the treatment of platinum-resistant and refractory ovarian cancer. |
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