您的位置:山东大学 -> 科技期刊社 -> 《山东大学学报(医学版)》

山东大学学报(医学版) ›› 2014, Vol. 52 ›› Issue (11): 55-59.doi: 10.6040/j.issn.1671-7554.0.2014.347

• 临床医学 • 上一篇    下一篇

重组人血管内皮抑素联合吉西他滨治疗铂类耐药复发卵巢癌的临床观察

张淼慈, 李萍, 哈敏文   

  1. 辽宁医学院附属第一医院肿瘤科, 辽宁 锦州 121000
  • 收稿日期:2014-05-28 发布日期:2014-11-10
  • 通讯作者: 哈敏文.E-mail:hmw2015@163.com E-mail:hmw2015@163.com

Clinical observation of recombinant human endostatin combined with gemcitabine in the treatment of platinum-resistant recurrent ovarian cancer

ZHANG Miaoci, LI Ping, HA Minwin   

  1. Department of Oncology, the First Affiliated Hospital of Liaoning Medical University, Jinzhou 121000, Liaoning, China
  • Received:2014-05-28 Published:2014-11-10

摘要: 目的 探讨重组人血管内皮抑素(恩度)联合吉西他滨治疗铂类耐药复发卵巢癌的疗效及安全性.方法 将64例铂类耐药复发卵巢癌患者随机分为两组,试验组33例接受恩度联合吉西他滨方案,对照组31例接受单药吉西他滨方案,比较两组临床疗效、不良反应和生活质量.结果 试验组与对照组的客观有效率(39.3% vs 16.1%)、疾病控制率(75.8% vs 41.9%)、中位无疾病进展生存期(6.5个月 vs 3.1个月)比较差异有统计学意义(P<0.05);两组中位生存期(13.7个月 vs 10.9个月)、不良反应和生活质量比较差异均无统计学意义(P>0.05).结论 恩度联合吉西他滨方案治疗铂类耐药复发卵巢癌,可提高患者的近期疗效及中位无疾病进展生存期,且不增加不良反应发生率.

关键词: 铂类耐药复发卵巢癌, 化学疗法,辅助, 吉西他滨, 重组人血管内皮抑素

Abstract: Objective To evaluate the efficacy and safety of recombinant human endostatin(endostar) in combination with gemcitabine in the treatment of platinum-resistant recurrent ovarian cancer. Methods A total of 64 patients with platinum-resistant recurrent ovarian cancer were randomly divided into the experimental group (n=33) and control group (n=31). The experimental group received endostar plus gemcitabine while the control group gemcitabine regimen alone. The efficacy, adverse reactions and quality of life were compared. Results Statistically significant differences were observed in the objective response rate, disease control rate and median progression-free survival between the experimental group and control group (39.3% vs 16.1%,75.8% vs 41.9%, 6.5 months vs 3.1 months, P<0.05). No statistically significant differences were found in the median overall survival (13.7 vs 10.9 months), adverse reactions and quality of life between the two groups (P>0.05). Conclusion Endostar in combination with gemcitabine significantly improves short-term effect and median progression-free survival in patients with platinum-resistant recurrent ovarian cancer without increasing the incidence of adverse effects.

Key words: Chemotherapy, adjuvant, Platinum-resistant recurrent ovarian cancer, Recombinant human endostatin, Gemcitabine

中图分类号: 

  • R737.31
[1] Mantia-Smaldone G M, Edwards R P,Vlad A M. Targeted treatment of recurrent platinum-resistant ovarian cancer:current and emerging therapies[J]. Cancer Manag Res, 2011, 3:25-38. DOI:10.2147/CMR.S8759.
[2] Pujade-Lauraine E, Hilpert F, Weber B, et al. Bevacizumab Combined With Chemotherapy for Platinum-Resistant Recurrent Ovarian Cancer:The AURELIA Open-Label Randomized Phase III Trial [J]. J Clin Oncol, 2014, 32(13):1302-1308.
[3] Matsuo K, Lin Y G, Roman L D, et al. Overcoming platinum resistance in ovarian carcinoma [J]. Expert Opin Investig Drugs, 2010, 19(11):1339-1354.
[4] Naumann R W, Coleman R L. Management strategies for recurrent platinum-resistant ovarian cancer [J]. Drugs, 2011, 71(11):1397-1412.
[5] Barber E L, Zsiros E, Lurain J R, et al. The combination of intravenous bevacizumab and metronomic oral cyclophosphamide is an effective regimen for platinum-resistant recurrent ovarian cancer [J]. J Gynecol Oncol, 2013, 24(3):258-264.
[6] Davis A, Tinker A V, Friedlander M. “Platinum resistant” ovarian cancer:what is it, who to treat and how to measure benefit ?[J] Gynecol Oncol, 2014, 133(3):624-631.
[7] Elit L, Hirte H. Palliative systemic therapy for women with recurrent epithelial ovarian cancer:current options [J]. Onco Targets Ther, 2013, 6:107-118 . DOI:10.2147/OTT.S30238.
[8] Tillmanns T D, Lowe M P, Walker M S, et al. Phase II clinical trial of bevacizumab with albumin-bound paclitaxel in patients with recurrent, platinum-resistant primary epithelial ovarian or primary peritoneal carcinoma [J]. Gynecol Oncol, 2013, 128(2):221-228.
[9] Folkman J. Tumor angiogenesis:therapeutic implications [J]. N Engl J Med, 1971, 285(21):1182-1186.
[10] Coleman R L, Brady W E, McMeekin D S, et al. A phase II evaluation of nanoparticle, albumin-bound (nab) paclitaxel in the treatment of recurrent or persistent platinum-resistant ovarian, fallopian tube, or primary peritoneal cancer:a Gynecologic Oncology Group study[J]. Gynecol Oncol, 2011, 122(1):111-115.
[11] 秦叔逵, 刘秀峰, 王琳, 等. 重组人血管内皮抑素与化疗联合治疗肺外晚期恶性肿瘤的临床研究[J]. 临床肿瘤学杂志, 2007, 12(10):728-735. QIN Shukui, LIU Xiufeng, WANG Lin, et al. Clinical study of endostar combined with chemotherapy for the multiple kind of advanced malignancies except lung cancer[J]. Chinese Clinical Oncology, 2007, 12(10):728-735.
[12] Jain R K. Normalization of tumor vasculature:an emerging concept in antiangiogenic therapy [J]. Science, 2005, 307(5706):58-62.
[13] Xu W J, Huang C, Wang J, et al. Comparison of the effects of recombinant human endostatin and docetaxel on human umbilical vein endothelial cells in different growth states[J]. Chin Med J (Engl), 2011, 124(18):2883-2889.
[14] 阿力木江·赛提瓦尔地, 张涛, 帕提古丽·阿尔西丁, 等. 重组人血管内皮抑素联合吉西他滨及顺铂治疗晚期非小细胞肺癌的临床分析[J]. 山东大学学报:医学版, 2013, 51(3):95-98. ALIMUJIANG·Stiwaerdi, ZHANG Tao, PATIGULI·Aerxiding, et al. Clinical analysis of recombinant human endostatin combined with gemcitabine and cisplatin therapy in advanced non-small cell lung cancer [J]. Journal of Shandong University (Health Sciences), 2013, 51(3):95-98.
[15] 刘春玲, 袁静, 顾国民. 重组人血管内皮抑素联合化疗治疗晚期非小细胞肺癌临床疗效[J]. 山东大学学报:医学版, 2011, 49(9):122-126. LIU Chunling, YUAN Jing, GU Guomin. Clinical observation of recombinant human endostatin combined with chemotherapy for advanced non-small cell lung cancer [J]. Journal of Shandong University (Health Sciences), 2011, 49(9):122-126.
[16] 赵长林, 唐磊, 殷江霞, 等. 重组人血管内皮抑素联合GC方案治疗晚期非小细胞肺癌1例[J]. 中国肺癌杂志, 2009, 12(5):460-462. ZHAO Changlin, TANG Lei, YIN Jiangxia, et al. Endostar combined GC in the treatment of advanced non-small cell lung cancer [J]. Chin J Lung Cancer, 2009, 12(5):460-462.
[17] 王金万, 孙燕, 刘永煜, 等. 重组人血管内皮抑素联合NP方案治疗晚期NSCLC 随机、 双盲、对照、多中心Ⅲ期临床研究[J]. 中国肺癌杂志, 2005, 8 (4):283-290. WANG Jinwan, SUN Yan, LIU Yongyu, et al. Results of randomized, multicenter, double blind phase Ⅲ trail of rh-endostatin (YH-16) in treatment of advanced nonsmall cell lung cancer patients [J]. Chin J Lung Cancer, 2005, 8(4):283-290.
[18] Zhang D W, Li H L, Yao Q, et al. The synergistic effect of recombinant human endostatin (YH-16) combined with oxaliplatin on human colorectal carcinoma[J]. J Int Med Res, 2010, 38(1):111-126.
[19] Van Moorselaar R J, Voest E E. Angiogenesis in prostate cancer:its role in disease progression and possible therapeutic approaches[J]. Mol Cell Endocrinol, 2002, 197(1-2):239-250.
[20] Bertolini F, Fusetti L, Mancuso P, et al. Endostatin, an antiangiogenic drug, induces tumor stabilization after chemotherapy or anti-CD20 therapy in a NOD/SCID mouse model of human high-grade non-Hodgkin lymphoma[J]. Blood, 2000, 96(1):282-287.
[21] Xu F, Ma Q, Sha H. Optimizing drug delivery for enhancing therapeutic efficacy of recombinant human endostatin in cancer treatment[J]. Crit Rev Ther Drug Carrier Syst, 2007, 24(5):445-492.
[22] 谢伟敏, 黄银梅. 血管内皮抑素治疗恶性肿瘤的研究进展[J]. 中国癌症防治杂志, 2009, 1(3):279-281. XIE Weimin, HUANG Yinmei. Advances in research on endostatin in the treatment of malignant tumor[J]. Chin J of Oncol Prev and Treat, 2009, 1(3):279-281.
[1] 殷雷,殷睿,李文佳,刘帅,吕家驹. CYLD抑制自噬提高膀胱癌细胞吉西他滨化疗敏感性[J]. 山东大学学报(医学版), 2017, 55(8): 1-6.
[2] 陈少平, 王旬果, 郭燕春, 刘瑞宝, 王芳. 重组人血管内皮抑素在晚期消化道肿瘤化疗中的应用[J]. 山东大学学报(医学版), 2014, 52(S1): 122-124.
[3] 徐晖, 聂春兰. 胰腺癌伴血清甲胎蛋白升高1例临床报告[J]. 山东大学学报(医学版), 2014, 52(S1): 120-121.
[4] 孙杰,牟晓燕,董雪丽. 舒尼替尼与吉西他滨联合及序贯应用对K-RAS突变A549细胞的影响[J]. 山东大学学报(医学版), 2014, 52(3): 45-49.
[5] 丁焕1,孙颖1,黎晓晴2,黎莉1. PARP抑制剂联合吉西他滨或多西他赛对雄激素非依赖性前列腺癌PC3细胞增殖的影响[J]. 山东大学学报(医学版), 2014, 52(1): 33-36.
[6] 阿力木江·赛提瓦尔地,张涛,帕提古丽·阿尔西丁,刘莉. 重组人血管内皮抑素联合吉西他滨及顺铂治疗晚期非小细胞肺癌的临床分析[J]. 山东大学学报(医学版), 2013, 51(3): 95-98.
[7] 刘春玲,袁静,顾国民. 重组人血管内皮抑素联合化疗治疗晚期非小细胞肺癌临床疗效[J]. 山东大学学报(医学版), 2011, 49(9): 122-.
[8] 杨宁,韩俊庆,盛巍. RRM1、ERCC1蛋白表达与晚期NSCLC患者GP方案化疗疗效及预后相关性分析[J]. 山东大学学报(医学版), 2011, 49(6): 89-93.
[9] 李红梅,李海霞,刘克为,王秀美 . 含顺铂三种化疗方案治疗非小细胞肺癌的临床研究[J]. 山东大学学报(医学版), 2007, 45(5): 499-502.
[10] 李玉亮,王永正,王晓华,张福君,朱立东,张万明,李 征,李振家,张开贤 . 动脉灌注吉西他滨联合125I粒子胰腺内植入治疗进展期胰腺癌[J]. 山东大学学报(医学版), 2007, 45(4): 393-396.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!