He Ying, Wang Jing, Xie Shuangshuang, Xue Qianlong
Department of Gynecology, The First Affiliated Hospital of Hebei North University, Zhangjiakou, China.
Department of Emergency, The First Affiliated Hospital of Hebei North University, Zhangjiakou, China.
Front Surg. 2022 May 16;9:908101. doi: 10.3389/fsurg.2022.908101. eCollection 2022.
To investigate the efficacy and safety of bevacizumab combined with pemetrexed in the treatment of recurrent and metastatic cervical cancer.
Clinical data of 65 patients with recurrent and metastatic cervical cancer who were admitted to our hospital were collected for retrospective analysis. All patients were administered with bevacizumab combined with pemetrexed for 4-6 cycles (21 days as 1 cycle). The short-term clinical efficacy and adverse reactions were compared between the two groups. In addition, the survival status of patients was followed up and recorded.
At least 4 cycles of chemotherapy were given to the 65 patients. There were 0 cases of complete response (CR), 14 cases of partial response (PR), 36 cases of stable disease (SD) and 15 cases of progressive disease (PD). The objective response rate (ORR) and the disease control rate (DCR) were 21.5% (14/65) and 76.9% (50/65), respectively. DCR was superior in patients with squamous cell carcinoma to that in those with adenocarcinoma (= 0.039), but no statistically significant difference was found in ORR. Patients with extra-pelvic metastatic lesions had a better efficacy than those with intra-pelvic metastatic lesions, but the difference was not statistically significant (> 0.05). The post-treatment adverse reactions mainly involved fatigue, nausea and vomiting, bleeding, leukopenia, anemia, thrombocytopenia, transaminase elevation, hypertension, proteinuria and neurotoxicity, most of which were grade I-II that ameliorated after symptomatic therapy. Grade III adverse reactions mainly included pain in 5 cases (7.7%), leukopenia in 17 cases (26.2%), anemia in 22 cases (33.8%), thrombocytopenia in 6 cases (9.2%), hypertension in 5 cases (7.7%) and neurotoxicity in 7 cases (10.8%). The follow-up results manifested that median overall survival (OS) and median progression-free survival (PFS) were 10.6 months and 6.6 months, respectively.
Bevacizumab combined with pemetrexed exhibits certain efficacy in the treatment of recurrent and metastatic cervical cancer, with tolerable adverse reactions. Therefore, this therapeutic option deserves clinical popularization and application.
探讨贝伐单抗联合培美曲塞治疗复发性和转移性宫颈癌的疗效及安全性。
收集我院收治的65例复发性和转移性宫颈癌患者的临床资料进行回顾性分析。所有患者均接受贝伐单抗联合培美曲塞治疗4 - 6个周期（21天为1个周期）。比较两组的短期临床疗效及不良反应。此外，对患者的生存状况进行随访并记录。
65例患者均接受了至少4个周期的化疗。完全缓解（CR）0例，部分缓解（PR）14例，病情稳定（SD）36例，病情进展（PD）15例。客观缓解率（ORR）和疾病控制率（DCR）分别为21.5%（14/65）和76.9%（50/65）。鳞状细胞癌患者的DCR优于腺癌患者（= 0.039），但ORR差异无统计学意义。盆腔外转移灶患者的疗效优于盆腔内转移灶患者，但差异无统计学意义（> 0.05）。治疗后不良反应主要包括乏力、恶心呕吐、出血、白细胞减少、贫血、血小板减少、转氨酶升高、高血压、蛋白尿及神经毒性，多数为Ⅰ - Ⅱ级，经对症治疗后好转。Ⅲ级不良反应主要包括疼痛5例（7.7%）、白细胞减少17例（26.2%）、贫血22例（33.8%）、血小板减少6例（9.2%）、高血压5例（7.7%）及神经毒性7例（10.8%）。随访结果显示，中位总生存期（OS）和中位无进展生存期（PFS）分别为10.6个月和6.6个月。
贝伐单抗联合培美曲塞治疗复发性和转移性宫颈癌有一定疗效，不良反应可耐受。因此，该治疗方案值得临床推广应用。
