贝伐珠单抗用于卵巢癌并腹腔积液患者腹腔热灌注化疗效果评价  

Evaluation of the Efficacy of Intraperitoneal Hyperthermic Perfusion Chemotherapy with Bevacizumab in Ovarian Cancer Patients with Ascites

作　　者：许倩 朱竞婧 王黎 XU Qian;ZHU Jingjing;WANG Li(Changde Hospital Affiliated to Xiangya School of Medicine,Central South University·The First People's Hospital of Changde,Changde,Hunan,China 415003)

机构地区：[1]中南大学湘雅医学院附属常德医院·湖南省常德市第一人民医院,湖南常德415003

出　　处：《中国药业》2025年第6期95-98,共4页China Pharmaceuticals

基　　金：湖南省常德市应用基础研究和临床医学研究类子项目[常科函〔2020〕75号]。

摘　　要：目的探讨贝伐珠单抗用于卵巢癌并腹腔积液患者腹腔热灌注化疗(HIPEC)的临床疗效。方法选取医院2019年8月至2023年8月收治的卵巢癌并腹腔积液患者86例,按随机数字表法分为观察组和对照组,各43例。两组患者均接受细胞减灭术联合术中TP方案(顺铂+紫杉醇)行HIPEC治疗,观察组患者在HIPEC中加用贝伐珠单抗,且两组均于术后3周内接受6周期(21 d为1周期)TP方案(奥沙利铂+紫杉醇)辅助化疗。结果观察组疾病控制率为83.72%,显著高于对照组的62.79%(P<0.05);观察组与对照组客观缓解率相当(58.14%经46.51%,P>0.05)。观察组患者治疗后的血清人附睾蛋白4、糖类抗原125和血管内皮生长因子水平均显著低于对照组(P<0.05)。观察组患者无进展生存期为30.48个月[95%CI(26.859,34.103)],显著长于对照组的22.99个月[95%CI(19.432,26.546)](P<0.05)。两组不良反应均仅Ⅰ级、Ⅱ级,不良反应总发生率比较无显著差异(P>0.05)。结论贝伐珠单抗用于卵巢癌并腹腔积液患者腹腔热灌注治疗,可有效降低患者血清肿瘤标志物表达水平,延长患者无进展生存期,且总体耐受性良好,不良反应可控。Objective To evaluate the clinical efficacy of bevacizumab in intraperitoneal hyperthermic perfusion chemotherapy(HIPEC)for ovarian cancer patients with ascites.Methods A total of 86 patients with ovarian cancer and ascites who were admitted to the hospital from August 2019 to August 2023 were selected and randomly divided into an observation group(n=43)and a control group(n=43)using a random number table.Both groups underwent cytoreductive surgery combined with intraoperative HIPEC using the TP regimen(cisplatin+paclitaxel).The observation group additionally received bevacizumab during HIPEC.Both groups received postoperative adjuvant chemotherapy with the TP regimen(oxaliplatin+paclitaxel)for six cycles(21 days per cycle)within three weeks after surgery.Results The disease control rate in the observation group was 83.72%,significantly higher than 62.79%in the control group(P<0.05).The objective response rate was comparable between the observation and control groups(58.14%vs.46.51%,P>0.05).After treatment,serum levels of human epididymis protein 4,carbohydrate antigen 125,and vascular endothelial growth factor were significantly lower in the observation group than in the control group(P<0.05).The progression-free survival(PFS)in the observation group was 30.48 months[95%CI(26.859,34.103)],significantly longer than 22.99 months in the control group[95%CI(19.432,26.546)](P<0.05).Both groups experienced only grade I–II adverse reactions,with no significant difference in the overall incidence of adverse reactions(P>0.05).Conclusion Bevacizumab in HIPEC for ovarian cancer patients with ascites effectively reduces serum tumor marker levels,prolongs progression-free survival,and demonstrates good overall tolerability with controllable adverse reactions.

关 键 词：卵巢癌 腹腔积液 腹腔热灌注化疗 贝伐珠单抗 肿瘤标志物 TP方案 

分 类 号：R969.4[医药卫生—药理学]