洛铂腹腔化疗在晚期上皮性卵巢癌患者中的效果研究  

A study on the curative effects of paclitaxel combined with lobaplatin intraperitoneal perfusion chemotherapy on advanced epithelial ovarian cancer

作　　者：刘雅坤[1] 马静[1] 王影[1] 贾雅静 张海波[1] LIU Yakun;MA Jing;WANG Ying(Department of Gynecology,The Fourth Hospital of Hebei Medical University,Hebei,Shijiazhuang 050011,China)

机构地区：[1]河北医科大学第四医院妇科,石家庄市050011

出　　处：《河北医药》2020年第17期2614-2617,共4页Hebei Medical Journal

基　　金：河北省医学科学研究重点课题计划(编号:20170735)。

摘　　要：目的探讨紫杉醇联合洛铂腹腔灌注化疗在晚期上皮性卵巢癌患者的临床疗效。方法回顾性分析2015年1月至2018年6月收治的晚期卵巢上皮性癌患者156例,患者分为洛铂组(n=80例)和卡铂组(n=76例)。洛铂组患者化疗首日给予175 mg/m^2紫杉醇静脉给药,次日给予洛铂腹腔灌注,剂量为30 mg/m^2、21 d为1个疗程,共6个疗程。卡铂组化疗首日给予175 mg/m^2紫杉醇静脉给药,次日给予卡铂腹腔灌注,剂量为AUC=5计算药量,共6个疗程。分析2组患者基线资料、化疗前后血清标志物CA125、HE4水平变化及炎性因子变化。对患者进行随访和满意度调查,随访截至日期2019年12月。对比2组患者化疗后的疗效、不良反应发生率情况。结果2组患者年龄、病理类型、FIGO分期和体能评分差异无统计学意义(P>0.05)。2组临床近期疗效显示,2组患者的缓解率均高于75%,但2组间比较差异无统计学意义(P>0.05)。2组不良反应结果,洛铂组骨髓抑制发生率低于卡铂组(P<0.05),尤其在白细胞发生率、血小板减少(P<0.05)。2组化疗后患者的血清肿瘤标记物CA125、HE4水平较化疗前均降低,差异无统计学意义(P>0.05)。2组患者化疗后较化疗前肿瘤坏死因子-α(TNF-α)、白介素-1β(IL-1β)水平降低;相对于卡铂组,洛铂组的IL-1β水平下降更明显,差异有统计学意义(P<0.05)。洛铂联合紫杉醇满意度更高(P<0.05)。结论紫杉醇联合洛铂或卡铂均为治疗晚期上皮性卵巢癌的有效化疗方案,临床近期疗效相当;与卡铂联合紫杉醇比较,紫杉醇联合洛铂的骨髓抑制发生率更低,能有效改善炎性因子水平,患者满意度更高。Objective To investigate the curative effects of paclitaxel combined with lobaplatin intraperitoneal perfusion chemotherapy on advanced epithelial ovarian cancer.Methods The clinical data about 156 patients with advanced epithelial ovarian cancer who were treated in our hospital from January 2015 to June 2018 were retrospectively analyzed.These patients were divided into lobaplatin group(n=80)and carboplatin group(n=76)according to different treatment drugs.The patients in lobaplatin group were given paclitaxel(175mg/m^2)by intravenous injection on the first day of chemotherapy,then were given lobaplatin intraperitoneal perfusion at next day,with a dose of 30mg/m^2,with 21-day as one treatment course,a total of 6 treatment courses.However thepatients in carboplatin group were given were given paclitaxel(175mg/m^2)by intravenous injection on the first day of chemotherapy,then were given carboplatin perfusion with the dosage AUC=5 at next day,a total of 6 treatment courses.The baseline data,and the changes of levels of serum markers CA125,HE4 and inflammatory factors before and after chemotherapy were observed and compared between the two groups.In addition the patients in both groups were followed up till December 2019 and the satisfaction degree of patients was investigated,moreover,the curative effects and incidence rates of adverse reactions after chemotherapy were observed and compared between the two groups.Results There were no significant differences in patient’s age,pathological type,FIGO stage and physical fitness score between the two groups(P>0.05).The remission rate in both groups was higher than 75%,however,the difference between the two groups was not statistically significant(P>0.05).The incidence rate of myelosuppression in lobaplatin group was significantly lower than that in carboplatin group,especially in the incidence rates of leukocyte decrease and thrombocytopenia(P<0.05).The serum levels of tumor markers CA125 and HE4 in both groups after chemotherapy were lower than those before chemother

关 键 词：上皮性卵巢癌 晚期 腹腔灌注 洛铂 卡铂 

分 类 号：R971.1[医药卫生—药品]