Efficacy Of Apatinib Mesylate Combined With Paclitaxel And Nedaplatin In The Treatment Of Recurrent Cervical Cancer

Background and ObjectiveThe 5-year survival rate of cervical cancer can reach 80%,but once cervical cancer relapses after standard initial treatment,the 5-year survival rate is only 50%.Most patients with cervical cancer relapse within 2 years after the initial treatment,and the treatment after recurrence is more difficult,which is the main cause of death of cervical cancer.In recent years,antiangiogenic drug therapy has become a hot topic in tumor therapy.Apatinib is a small molecule antiangiogenic drug researched independently in China,but it is rarely studied in cervical cancer.Therefore,the safety and efficacy of apatinib mesylate combined with paclitaxel and nedaplatin in the treatment of first-time recurrent cervical cancer were studied,and the risk factors affecting the prognosis of recurrent cervical cancer were analyzed,so as to provide basis for clinical diagnosis and treatment.Materials and Methods1.Materials source:58 patients with recurrent cervical cancer from August 1,2016 to August 1,2019 in the First Affiliated Hospital of Zhengzhou University were selected and their clinical data were retrospectively analyzed.Paclitaxel and nedaplatin regimens were used as control group,and apatinib mesylate combined with paclitaxel and nedaplatin regimens were used as experimental group.2.Research content:analyze the near and far curative effect and adverse reactions of the two groups of patients,sort out and analyze the clinical characteristics of 58.patients with recurrent cervical cancer,and analyze the influence of these characteristics on their prognosis.3.Statistical methods:SPSS 26.0 was chosen for statistical analysis.Use P=0.05 as inspection level.Results1.A total of 58 patients were included in the study,and they were divided into the treatment group(n=27)and the control group(n=31).There was no significant difference in the general information between the two groups(P>0.05).2.In the experimental group,CR was 3.7%,PR was 40.7%,SD was 40.7%,and PD was 14.8%.In the control group,CR was 0%,PR was 19.4%,SD was 54.9%,and PD was 25.8%.There was significant difference in the short-term efficacy between the two groups(P<0.05).The ORR of the two groups were 44.4%and 19.4%,the difference was statistically significant(P<0.05),the DCR of the two groups were 85.2%and 74.2%,the difference was not statistically significant(P>0.05).3.The median PFS of the experimental group was 11.8 months(95%confidence interval:10.443-13.157 months),and that of the control group was 9.0 months(95%confidence interval:6.82-11.18 months).The difference of PFS survival curve between the two groups was statistically significant(P<0.05),indicating that the prognosis of the experimental group was better than that of the control group.4.In the experimental group,there were 14 cases of hypertension,including 13 cases of grade Ⅰ-Ⅱ and 1 case of grade Ⅲ-Ⅳ,19 cases of proteinuria,including 15 cases of grade Ⅰ-Ⅱ and 4 cases of grade Ⅲ-Ⅳ,17 cases of hand foot syndrome,including 13 cases of grade Ⅰ-Ⅱ and 4 cases of grade Ⅲ-Ⅳ,13 cases of oral mucositis,all of which were grade Ⅰ-Ⅱ,14 cases of diarrhea,all of which were grade Ⅰ-Ⅱ,The difference of proteinuria,hand foot syndrome,oral mucositis and diarrhea between experimental group and control group was statistically significant(P<0.05).There was no significant difference in the incidence of leukopenia,anemia,thrombocytopenia,liver function damage,nausea,vomiting and fatigue between the experimental group and the control group(P>0.05).There was no death related to adverse reactions in the experimental group and the control group.5.Age,application of apatinib and recurrent site were independent factors affecting the prognosis of recurrent cervical cancer(P<0.05).The risk of disease progression in chemotherapy alone group was 2.69 times higher than that in combination group,the risk of disease progression was 2.78 times that of local recurrence,The risk of disease progression in distant recurrence group was 5.36 times higher than that in local recurrence group.Therefore,the absence of apatinib and recurrent site are the risk factors for the progression of recurrent cervical cancer.Conclusion1.Apatinib combined with chemotherapy can prolong PFS in patients with recurrent cervical cancer and is well tolerated.Apatinib combined with chemotherapy mesylate is recommended for the treatment of recurrent cervical cancer.2.Different recurrent sites affect the prognosis of recurrent cervical cancer.The risk of distant recurrent disease progression is the highest,and the risk of local recurrent disease progression is relatively low.Therefore,regular follow-up and early detection of recurrence are expected to improve the outcome of patients.