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贝伐珠单抗联合紫杉醇+卡铂治疗持续性或复发性宫颈癌的临

床观察
Δ

张力忆 ，蒋奉希，桂定清（达州市中心医院妇产科，四川 达州 635000）
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中图分类号 R969.4；R979.1 文献标志码 A 文章编号 1001-0408（2024）17-2126-05
DOI 10.6039/j.issn.1001-0408.2024.17.12

摘 要 目的 探讨贝伐珠单抗联合紫杉醇（PTX）+卡铂（CBP）化疗方案治疗持续性或复发性宫颈癌的近远期疗效，以及对患者
生存质量、肿瘤标志物和安全性的影响。方法 采用随机数字表法将我院2020年1月－2022年10月收治的持续性或复发性宫颈
癌患者80例分为对照组（40例）与观察组（40例）。两组患者均接受PTX+CBP化疗，观察组患者同时联用贝伐珠单抗治疗，均连续
治疗6个周期。比较两组患者的近期疗效、毒副反应发生情况以及治疗前和全部疗程结束时的欧洲癌症研究与治疗组织生活质
量核心问卷量表30（EORTC QLQ-C30）评分、血清肿瘤标志物[癌胚抗原（CEA）、糖类抗原125（CA125）、鳞状细胞癌抗原（SCCA）]
水平。采用 Kaplan-Meier 法绘制两组患者的生存曲线并通过 Log-rank 检验比较两组患者的无进展生存期（PFS）和总生存期
（OS）。结果 观察组患者的客观有效率显著高于对照组（62.50% vs. 35.00%，P＜0.05），中位PFS（9.30个月 vs. 6.30个月）和中位
OS（14.90个月 vs. 10.60个月）均显著长于对照组（P＜0.05），治疗后的EORTC QLQ-C30评分显著高于对照组（P＜0.05）。相较于
治疗前，两组患者治疗后的血清 CEA、CA125 和 SCCA 水平均显著降低（P＜0.05），且观察组患者较对照组的降低幅度更大（P＜
0.05）。两组患者治疗期间各类型毒副反应分级比较，差异无统计学意义（P＞0.05）；多数患者的毒副反应在停药后1～2个月自动
消失或在对症治疗后消失。结论 贝伐珠单抗联合PTX+CBP化疗方案可有效提高持续性或复发性宫颈癌患者的客观有效率，降
低血清肿瘤标志物水平，提升患者生存质量，延长患者生存期，且安全性良好。
关键词 持续性宫颈癌；复发性宫颈癌；贝伐珠单抗；紫杉醇；卡铂；临床疗效；生存质量；肿瘤标志物；安全性

Clinical observation of bevacizumab combined with paclitaxel and carboplatin chemotherapy in the
treatment of persistent or recurrent cervical cancer
ZHANG Liyi，JIANG Fengxi，GUI Dingqing（Dept. of Gynaecology and Obstetrics， Dazhou Central Hospital，
Sichuan Dazhou 635000， China）

ABSTRACT OBJECTIVE To explore the short-term and long-term efficacy of bevacizumab combined with paclitaxel （PTX）
and carboplatin （CBP） chemotherapy in the treatment of persistent or recurrent cervical cancer， as well as its impact on patient
quality of life， tumor markers and safety. METHODS Totally 80 patients with persistent or recurrent cervical cancer admitted to
our hospital from January 2020 to October 2022 were randomly divided into control group （40 cases） and observation group （40
cases） using a random number table method. Both groups received PTX+CBP chemotherapy， while the observation group was
treated with bevacizumab in combination. Both groups were treated continuously for 6 cycles. The recent efficacy， the incidence of
toxic side effects as well as European Organization for Research and Treatment of Cancer Life Questionnaire Core 30 （EORTC
QLQ-C30） scores， and the serum tumor markers [carcinoembryonic antigen （CEA）， carbohydrate antigen 125 （CA125）， and
squamous cell carcinoma antigen （SCCA）] levels before and at the end of the entire course of treatment were compared between
two groups. The survival curves of the two groups were drawn by using Kaplan-Meier method， and progression-free survival （PFS）
and overall survival （OS） were compared between the two groups by Log-rank test. RESULTS The objective response rate of the
observation group was significantly higher than that of the control group （62.50% vs. 35.00%， P＜0.05）， and the median PFS
（9.30 months vs. 6.30 months） and median OS （14.90 months vs. 10.60 months） were also significantly longer than the control
group （P＜0.05）. EORTC QLQ-C30 score of the observation group after treatment was significantly higher than that of the control
group （P＜0.05）. Compared to before treatment， the serum levels of CEA， CA125 and SCCA in both groups were significantly
reduced after treatment （P＜0.05）， while the observation group had a larger decrease （P＜0.05）. There was no significant
difference in the grading of various types of toxic side effects between the two groups during treatment （P＞0.05）. Most patients
experienced automatic disappearance of toxic side effects 1-2 months after discontinuation of medication， or symptoms
disappearance after symptomatic treatment. CONCLUSIONS The combination of bevacizumab and PTX+CBP chemotherapy
regimen can effectively improve the objective efficacy rate of
persistent or recurrent cervical cancer， reduce serum tumor
Δ 基金项目 四川省自然科学基金项目（No.S22009）
＊第一作者 副主任医师，硕士。研究方向：妇科肿瘤。E-mail： marker levels， improve patient quality of life， prolong
zly29225079@163.com survival， and have good safety.

· 2126 · China Pharmacy 2024 Vol. 35 No. 17 中国药房 2024年第35卷第17期