白蛋白结合型紫杉醇与溶剂型紫杉醇用于晚期上皮性卵巢癌新辅助化疗的疗效及安全性比较  

Comparison of Efficacy and Safety of Albumin Bound Paclitaxel and Solvent Based Paclitaxel in Neoadjuvant Chemotherapy for Advanced Epithelial Ovarian Cancer

作　　者：王金凤 王宇琪 张欣欣[2] 尹盼月 赵蓝波 李奇灵[1] WANG Jinfeng;WANG Yuqi;ZHANG Xinxin(Department of Obstetrics and Gynecology,First Affiliated Hospital of Xi′an Jiaotong University,Xi′an Shaanxi 710061,China;Medical Information Management,First Affiliated Hospital of Xi′an Jiaotong University,Xi′an Shaanxi 710061,China)

机构地区：[1]西安交通大学第一附属医院妇产科,陕西西安710061 [2]西安交通大学第一附属医院医疗信息管理,陕西西安710061

出　　处：《实用妇产科杂志》2024年第9期717-722,共6页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:探讨白蛋白结合型紫杉醇(nab-PTX)与溶剂型紫杉醇(sb-PTX)用于晚期上皮性卵巢癌(EOC)新辅助化疗(NACT)的疗效及安全性。方法:回顾性分析2018年6月11日至2023年9月19日于西安交通大学第一附属医院收治术前行NACT的晚期EOC 107例患者的临床资料,其中使用nab-PTX联合卡铂静脉化疗52例(nab-PTX组),使用sb-PTX联合卡铂静脉化疗55例(sb-PTX组)。比较两组患者NACT后的临床指标和肿瘤细胞减灭术的术中情况及NACT的不良反应等。结果:nab-PTX组NACT后肿瘤最大直径(3.7 cm vs.3.8 cm)、CA125(28.9 U/ml vs.31.6 U/ml)及HE4(102.5 U/ml vs.119.0 U/ml)明显低于sb-PTX组,差异均有统计学意义(P<0.001);nab-PTX组NACT后的总入量(2580 ml vs.2100 ml)、手术复杂性评分(SCS)中等占比(36.54%vs.18.18%)和淋巴结切除率(57.69%vs.29.09%)显著高于sb-PTX组(P<0.05)。两组NACT后的腹水量、临床疗效评价、客观缓解率(ORR)、疾病控制率(DCR)、手术时间、术中出血量、总出量、术后住院时间、手术满意度、病理完全缓解率(pCR)、输注血制品、淋巴结转移率以及NACT期间出现的化疗不良反应差异均无统计学意义(P>0.05)。结论:nab-PTX用于NACT对疾病的临床控制优于sb-PTX,以实现更佳的肿瘤细胞减灭术,但其对病理缓解无显著作用,二者药物安全性方面相似。Objective:To evaluate the efficacy and safety of albumin bound paclitaxel(nab-PTX)and solvent based paclitaxel(sb-PTX)in neoadjuvant chemotherapy(NACT)for advanced epithelial ovarian cancer(EOC).Methods:A retrospective analysis was conducted on the clinical data of 107 patients with advanced EOC who underwent preoperative NACT in the First Affiliated Hospital of Xi′an Jiaotong University from June 11,2018 to September 19,2023.Among them,52 patients were treated with nab-PTX combined with carboplatin intravenous chemotherapy(nab-PTX group),and 55 with sb-PTX combined with carboplatin intravenous chemotherapy(sb-PTX group).The clinical indicators after NACT,intraoperative conditions of cytoreductive surgery and adverse events during the NACT were compared in two groups.Results:The maximum tumor diameter(3.7 cm vs.3.8 cm),CA125(28.9 U/ml vs.31.6 U/ml)and HE4(102.5 U/ml vs.119.0 U/ml)levels in the nab PTX group after NACT were significantly lower than those in the sb-PTX group,and the differences were statistically significant(P<0.001).After NACT,the total input(2580 ml vs.2100 ml),the proportion of surgical complexity score(36.54%vs.18.18%),and lymph node resection rate(57.69%vs.29.09%)in the nab-PTX group were significantly higher than those in the sb-PTX group(P<0.05).There was no statistically significant difference(P>0.05)in the amount of ascites,clinical efficacy evaluation,ORR,DCR,surgical time,intraoperative bleeding,total output,postoperative hospital stays,surgical satisfaction,pathological complete response rate(pCR),transfusion of blood products,lymph node metastasis and adverse effects during NACT between the two groups.Conclusions:Nab-PTX has a better clinical disease control effect than sb-PTX in NACT,in order to achieve better cy-toreductive surgery,but it has no significant effect on pathological remission.The safety of the two drugs is similar.

关 键 词：卵巢癌 新辅助化疗 白蛋白结合型紫杉醇 溶剂型紫杉醇 

分 类 号：R737.31[医药卫生—肿瘤]