| BackgroundOvarian cancer is the most fatal gynecological cancer,more than 90 percent of these arise from epithelial cells.The operation was followed by platinum-based chemotherapy for more than 15 years,the long-term repeated application of single chemotherapy regimen can increase the risk of acquired drug resistance.Paclitaxel as a chemotherapy drug,has the effect of inhibiting the proliferation of cancer cells;Apatinib is an inhibitor of VEGF-2 and has obvious anti-tumor angiogenesis effect.A large number of studies have shown that apatinib is effective in patients with advanced gastric cancer,but the study of apatinib in ovarian cancer is limited,moreover,the efficacy of apatinib combined with paclitaxel in patients with recurrent platinum-resistant ovarian cancer needs to be further explored.ObjectiveTo investigate the clinical efficacy and adverse reactions of apatinib combined with paclitaxel monotherapy in patients with relapsed platinum-resistant ovarian cancer.MethodsPatients with ovarian epithelial malignant tumor diagnosed by postoperative pathology and admitted to the First Affiliated Hospital of Xinxiang Medical College from September2018 to July 2019 were selected as study subjects.All patients had been treated with satisfactory surgical treatment,combined with platinum based intravenous chemotherapy and intraperitoneal hyperthermic perfusion chemotherapy and showed drug resistance.Patients were divided into experimental group and control group according to strict inclusion criteria and exclusion criteria.A total of 52 cases were eventually included in the study,with26 cases in each group.Before chemotherapy,Patients in both groups had been given preconditioning such as allergy prevention,antiemetic,liver protection,prevention of leukopenia and thrombocytopenia.On this basis,The experimental group was given paclitaxel single drug chemotherapy plus apatinib combined treatment,and the control group was given paclitaxel single drug chemotherapy.The efficacy was assessed by the following criteria:progression-free survival(PFS),complete response(CR)partial response(PR)stabilization(SD)disease progression(PD)objective response(ORR)disease control(DCR)and changes in CA125 values before and after treatment.The adverse reactions were analyzed according to the evaluation criteria of common adverse events.All patients were given Karnofsky health score before and after treatment.Results1.The median progression free survival was 8.9 months and 6.9 months in the experimental group and control group.The difference was statistically significant(Log-Rankχ~2=4.437,P<0.05).2.The ORR and DCR of the experimental group and the control group after treatment were 53.84%(14/26)、23.08%(6/26)、92.31%(24/26)and 69.23%(18/26),respectively,the ORR and DCR of the experimental group were higher than those of the control group(χ~2=5.200,P<0.05;χ~2=4.457,P<0.05),and the differences were statistically significant(P<0.05).CR and PR in the experimental group were 3.85%(1/26)and 50%(13/26),which were significantly higher than those in the control group,and SD and PD were 38.46%(10/26)and 7.69%(2/26),which were significantly lower than those in the control group.3.After treatment,there were significant differences in CA125 values between the two groups,(101.12±24.58)U/ml,(150.70±19.86)U/ml,and the differences were statistically significant(P<0.05).4.After treatment,Compared with the control group,the incidence of hypertension in the experimental group,was higher than that in the control group,and the difference was statistically significant(χ~2=9.665,P<0.05),but there was no significant difference in the incidence of gastrointestinal reaction,fatigue,hand-foot syndrome,anemia,alopecia and leukopenia(P>0.05).5.There was no significant difference in Karnofsky health score between the two groups before treatment(63.45±2.96,63.33±2.75)points,which was not statistically significant(P>0.05).After treatment,the Karnofsky health score of the experimental group was higher than the control group,with significant difference(82.13±2.78,71.21±3.07)points,and the difference was statistically significant(P<0.05).ConclusionsApatinib targeted drugs combined with paclitaxel single drug chemotherapy can improve the clinical efficacy of patients with recurrent platinum-resistant ovarian cancer,adverse reactions can be controlled better,improve the prognosis of patients. |
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