不同剂量奥拉帕利联合贝伐珠单抗治疗老年复发性铂敏感型卵巢癌的效果分析  

Effect Analysis of Different Doses of Olaparib Combined with Bevacizumab in the Treatment of Platinum-sensitive Recurrent Ovarian Cancer in the Elderly

作　　者：王胜南 马哲 马雪娇 WANG Shengnan;MA Zhe;MA Xuejiao(Department of Internal Medicine,Langfang People's Hospital,Langfang,Hebei 065000,China;Department of Obstetrics and Gynecology,Dingzhou People's Hospital,Dingzhou,Hebei 070000,China)

机构地区：[1]廊坊市人民医院内科,河北廊坊065000 [2]定州市人民医院妇产科,河北定州070000

出　　处：《临床误诊误治》2025年第4期43-49,共7页Clinical Misdiagnosis & Mistherapy

基　　金：2022年度河北省医学科学研究课题计划(20220439)。

摘　　要：目的分析不同剂量奥拉帕利联合贝伐珠单抗对老年复发性铂敏感型卵巢癌患者临床疗效、血清肿瘤标志物及T淋巴细胞亚群的影响。方法选取2019年1月至2021年1月确诊的老年复发性铂敏感型卵巢癌患者140例,以信封法随机分为高剂量组、低剂量组,每组70例。低剂量组给予奥拉帕利150 mg口服2/d联合贝伐珠单抗注射液治疗,高剂量组给予奥拉帕利300 mg口服2/d联合贝伐珠单抗注射液治疗。观察2组中位无进展生存期、疾病控制率、客观缓解率以及治疗期间药物不良反应发生率。比较2组治疗前及治疗2、4、6个周期血清肿瘤标志物[人附睾蛋白4(HE4)、癌抗原125(CA125)、癌抗原199(CA199)]、T淋巴细胞亚群水平及生命质量量表评分。结果治疗结束后,2组客观缓解率、疾病控制率比较差异无统计学意义(P>0.05)。与治疗前比较,2组治疗2、4、6个周期生命质量量表评分及外周血CD3+、CD4+、CD4+/CD8+水平逐步升高,血清HE4、CA125、CA199水平逐渐下降(P<0.05)。治疗后2、4、6个周期,低剂量组生命质量量表评分及外周血CD3+、CD4+、CD4+/CD8+水平高于高剂量组(P<0.05),但血清HE4、CA125,CA199水平比较差异无统计学意义(P>0.05)。低剂量组药物不良反应发生率均低于高剂量组(P<0.05)。随访3年,2组中位无进展生存期比较差异无统计学意义(P>0.05)。结论低剂量奥拉帕利联合贝伐珠单抗治疗老年复发性铂敏感型卵巢癌患者临床效果较好,药物不良反应发生率低,安全性较高。Objective To analyze the effects of different doses of Olaparib combined with Bevacizumab on clinical efficacy,serum tumor markers and T lymphocyte subsets in elderly patients with platinum-sensitive recurrent ovarian cancer.Methods A total of 140 elderly patients with platinum-sensitive recurrent ovarian cancer diagnosed from January 2019 to January 2021 were randomly divided into high-dose group(n=70)and low-dose group(n=70)by envelope method.The low-dose group was treated with Olaparib(150 mg orally,2/d)combined with Bevacizumab injection,and the high-dose group was treated with Olaparib(300 mg orally,2/d)combined with Bevacizumab injection.The median progression-free survival(PFS),disease control rate(DCR),objective response rate(ORR)and the incidence of adverse drug reactions during treatment were observed.Serum tumor markers[human epididymal protein 4(HE4),cancer antigen 125(CA125),cancer antigen 199(CA199)],T lymphocyte subsets and quality of life scale scores were compared between the two groups before treatment and after 2,4 and 6 cycles of treatment.Results After treatment,there was no significant difference in ORR and DCR between the two groups(P>0.05).Compared with those before treatment,life quality scale scores and peripheral blood CD3+,CD4+,CD4+/CD8+levels in the two groups after 2,4 and 6 cycles of treatment were gradually increased,while serum HE4,CA125 and CA199 levels were gradually decreased(P<0.05).After 2,4 and 6 cycles of treatment,quality of life scale scores and peripheral blood CD3+,CD4+,CD4+/CD8+levels in low-dose group were higher than those in high-dose group(P<0.05);however,there was no significant difference in serum HE4,CA125 and CA199 levels between the two groups(P>0.05).The incidence of adverse drug reactions in low-dose group was lower than that in high-dose group(P<0.05).After 3 years of follow-up,there was no significant difference in median PFS between the two groups(P>0.05).Conclusion Low-dose Olaparib combined with Bevacizumab in the treatment of elderly patients with plat

关 键 词：卵巢肿瘤 奥拉帕利 贝伐珠单抗 人附睾蛋白4 癌抗原125 生活质量 T淋巴细胞亚群 不良反应 

分 类 号：R737.31[医药卫生—肿瘤]