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目的 探讨贝伐珠单抗联合新辅助化疗治疗晚期卵巢癌患者的临床疗效及安全性。方法 前瞻性选取新乡医学院第一附属医院于2020年5月至2023年5月收治的92例晚期卵巢癌患者，采用随机数字表法将患者分为贝伐珠单抗组(46例，采用贝伐珠单抗联合紫杉醇+卡铂化疗方案)及紫杉醇组(46例，采用紫杉醇+卡铂化疗方案)。比较贝伐珠单抗组和紫杉醇组患者治疗3个周期后的治疗效果、血清癌抗原125(CA125)的变化及不良反应发生情况。采用Kaplan-Meier分析贝伐珠单抗组和紫杉醇组患者的预后情况。结果 贝伐珠单抗组总有效率为58.70%(27/46)、疾病控制率为89.13%(41/46)，均高于紫杉醇组的36.96%(17/46)和69.57%(32/46)，差异有统计学意义(χ2=4.356、5.373，均P<0.05)。治疗后，贝伐珠单抗组血清CA125水平下降幅度(309.56±43.12)U/mL大于紫杉醇组(291.36±40.92)U/mL，差异有统计学意义(t=4.209,P<0.05)。在胃肠道反应、贫血、蛋白尿、骨髓抑制、高血压、出血的发生率方面，贝伐珠单抗组和紫杉醇组比较，差异无统计学意义(P>0.05)。在完成间歇性肿瘤细胞减灭术的患者中，贝伐珠单抗组R0切除率为79.41%(27/34)，紫杉醇组为53.57%(15/28)，差异具有统计学意义(χ2=4.692,P<0.05)。Kaplan-Meier分析结果显示，贝伐珠单抗组2年总生存率84.2%(95%CI:73.4%～95.0%)大于紫杉醇组的64.7%(95%CI:50.8%～78.6%)，差异有统计学意义(Log-rankχ2=4.994,P<0.05)。结论 贝伐珠单抗联合新辅助化疗较单纯新辅助化疗对晚期卵巢癌患者的疗效更优，可有效降低肿瘤标志物水平，延长患者的总生存期，且治疗安全性可控。
Abstract：Objective To investigate the clinical efficacy and safety of bevacizumab combined with neoadjuvant chemotherapy in the treatment of advanced ovarian cancer. Methods In this prospective study, 92 patients with advanced ovarian cancer treated at the First Affiliated Hospital of Xinxiang Medical University from May 2020 to May 2023 were randomly assigned to the bevacizumab group(n=46, receiving bevacizumab plus paclitaxel and carboplatin chemotherapy) and the paclitaxel group(n=46, receiving paclitaxel and carboplatin chemotherapy) according to the random number table method. The therapeutic efficacy, changes in serum tumor marker cancer antigen 125(CA125), and the incidence of adverse reactions were compared between the bevacizumab group and the paclitaxel group after 3 cycles of treatment. The Kaplan-Meier analysis was used to analyze the prognosis of of patients in the bevacizumab group and the paclitaxel group. Results The total effective rate was 58.70%(27/46) and the disease control rate was 89.13%(41/46) in the bevacizumab group, higher than those in the paclitaxel group(36.96%(17/46) and 69.57%(32/46), respectively), and the differences were statistically significant(χ2=4.356 and 5.373, both P<0.05). After treatment, the reduction in serum CA125 levels in the bevacizumab group(309.56±43.12) U/mL was greater than that in the paclitaxel group(291.36±40.92) U/mL, and the difference was statistically significant(t=4.209, P<0.05). There was no statistically significant difference in the incidence of gastrointestinal reactions, anemia, proteinuria, bone marrow suppression, hypertension, and bleeding between the two groups(P>0.05). Among the patients who underwent interval debulking surgery, the R0 resection rate in the bevacizumab group was 79.41%(27/34), higher than 53.57%(15/28) in the paclitaxel group, and the difference was statistically significant(χ2=4.692, P<0.05). Kaplan-Meier analysis showed that the 2-year overall survival rate in the bevacizumab group(84.2%, 95% CI: 73.4% to 95.0%) was significantly higher than that in the paclitaxel group(64.7%, 95% CI: 50.8% to 78.6%), with a statistically significant difference(Log Rank χ2=4.994, P<0.05). Conclusion Compared with neoadjuvant chemotherapy alone, bevacizumab combined with neoadjuvant chemotherapy demonstrates superior efficacy in patients with advanced ovarian cancer. It effectively reduces tumor marker levels, prolongs overall survival, and has a controllable safety profile.
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中图分类号:R737.31
引用信息:
[1]张彦,王淑华,王慧玲,等.贝伐珠单抗联合新辅助化疗治疗晚期卵巢癌患者的临床疗效[J].中国药物应用与监测,2026,23(01):16-21.
2026-01-25
2026-01-25