| Objective: Ovarian cancer with its high incidence rate,low early detection rate and worse prognosis ranks the first in gynecological malignancy tumor in the aspect of mortality rate.Though the causes of ovarian cancer are not completely clear,endocrine,genetics and environment are all the factors affecting the incidence of ovarian cancer.Currently the treatment option of ovarian cancer is limited;surgery is still the primary option.However surgery is usually unable to remove all the lesions due to the facts that most patients are found as advanced cancer patient with cancer's fast proliferation.Radiotherapy is not so satisfied and patients need to take chemotherapy which has more damages to human tissues and serious side effects.Therefore,patients with advanced cancer cannot dream of quality of life.For all the reasons above,searching effective treatment methods is at the edge.With the development of science,target-therapy has become the hotpot for research malignant tumor.Among them VEGF inhibitor has been widely applied in the treatment of various malignant tumors.However in the process of clinical treatment for ovarian cancer,target-therapy research and application is not mature.Apatinib mesylate is VEGF inhibitor independently researched by China,which can selectively block vascular endothelial growth factor receptor 2 and its downstream signaling pathways to inhibit the proliferation and migration of vascular endothelial cells.In this way,the growth of tumor can be inhibited.Fact is that there is less option for third-line chemotherapy of ovarian cancer,and treatment method is limited,therefore maybe target-therapy can be one of the treatments for advanced ovarian cancer.With related clinical non-extensive application,this research will observe short-term efficacy and safety of Apatinib mesylate combined chemotherapy to ovarian cancer patients with drug resistance after reoccurrence.Method: This experiment is strictly in accordance with the selection criteria and exclusion criteria collecting 46 patients with ovarian cancer whose second line chemotherapy has been failed during the time period of Feb,2016 to Nov 2017 in The first affiliated Hospital of Hebei North University.These 46 patients have been divided into experiment group-21 patients and control group-25 patients.The experiment group will be treated with combined chemotherapy option of Apatinib together with taxanes and anthracyclines.Apatinib is taken orally at the dose of 500mg/day continually till disease progression or patient can no longer undertake,while the control group is treated with taxane or anthracycline chemotherapy alone.All the patients will take full-body CT check and Serological tests before enrolling group.Each patient has at least one measurable targeted lesion.Patients should recheck CT and tumor markers each 2 courses of chemotherapy,and should recheck blood,urine routine and liver and kidney function each course at the same time of close-monitored in the aspects of objective lesions,adverse reactions and life quality.The treatment effects and adverse reactions should be compared between experiment group and control group.Result: After 6 courses,the result is that experiment result is better than control group.The objective remission rete of Experiment group is 47.62%,of control group is 16.00%.The disease control rate of Experiment group is 76.19%,of control group is 44.00%.The difference is statistically significant(p<0.05).Also malignant effusion of one patient with pleural effusion and one with celiac effusion in Experiment group have been both reduced 2 orders of magnitude.According to the recorded liver and kidney function value during the experiment process,both the 2 groups have not been found obvious liver and kidney function damage.Adverse reactions of Experiment group are mainly hand and foot syndrome,hypertension,leukopenia,nausea and vomiting,diarrhea and etc.Hand and foot syndrome,hypertension of control group are not so obvious,the others are similar.All the adverse reactions are grade 1 and 2.The hand and foot syndrome and hypertension of Experiment group are with high incidence rate mainly because of using of Apatinib.There was no statistically significant difference in the incidence of adverse reactions(P > 0.05).Conclusion:To sum up,the path for second-line treatment with combination chemotherapy treatment failure of advanced ovarian cancer has good curative effect,and adverse reactions can be tolerated,and the research result is of great significance to the third line treatment of ovarian cancer research,brought new hope for patients with advanced ovarian cancer. |
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