贝伐珠单抗联合化疗治疗晚期卵巢癌所致粘连性肠梗阻的疗效观察

目的:观察腹腔灌注贝伐珠单抗联合化疗治疗卵巢癌所致粘连性肠梗阻的临床疗效，分析腹腔内血管内皮生长因子(VEGF)水平对贝伐珠单抗治疗卵巢癌腹腔粘连的临床意义。方法:将62例卵巢癌伴恶性不完全性肠梗阻患者随机分为实验组(n=32)和对照组(n=30)，均用奥曲肽(60 mg/d连续3天)全身治疗，3周重复1次;同时腹腔内给予灌注化疗，每3周重复1次，连续治疗2周期。对照组给予吉西他滨和卡铂腹腔灌注治疗，实验组在上述治疗基础上联合贝伐珠单抗（5 mg/kg）治疗。评价患者疗效、不良反应。酶联免疫吸附法(ELISA)检测62例患者治疗前、后腹腔中VEGF水平。结果:实验组的有效率为87.50%，对照组为43.33%，差异有统计学意义(P＜0.05)。实验组和对照组患者耐受良好，不良反应无明显差异。治疗后对照组腹水VEGF水平为(139.89±10.89)pg/mL，明显低于治疗前的(310.59±13.63)pg/mL(P＜0.05);实验组治疗后腹水VEGF水平为(81.57±4.71)pg/mL，明显低于治疗前的(309.67±11.02)pg/mL(P＜0.05)。治疗后VEGF水平实验组较对照组下降更为显著(P＜0.05)。结论:贝伐珠单抗联合化疗治疗晚期卵巢癌粘连性肠梗阻优于单纯腹腔灌注化疗，不良反应较少，安全性耐受性好。

Observation of efficacy of bevacizumab combined with chemotherapy in the treatment of adhesion intestinal obstruction caused by advanced ovarian cancer

Objective:To observe the clinical efficacy of intraperitoneal infusion of bevacizumab combined with chemotherapy in the treatment of adhesive intestinal obstruction caused by ovarian cancer,and to analyze the clinical significance of intravascular vascular endothelial growth factor (VEGF) level in the treatment of ovarian cancer peritoneal effusion with bevacizumab.Methods:62 patients with ovarian cancer with malignant incomplete intestinal obstruction were randomly divided into an experimental group (n=32) and a control group (n=30).All patients were treated with octreotide (60 mg/d for 3 consecutive days) for 3 weeks,with intraperitoneal perfusion chemotherapy combined with gemcitabine (1 000 mg/m2) and carboplatin (AUC=5) as control group.The experimental group was treated with bevacizumab (5 mg/kg) based on the basis of treatment,repeated every 3 weeks for 6 weeks.The curative effect and adverse reactions were evaluated.The concentration of VEGF of two groups was assayed by ELISA method before and after treatment．Results:The effective rate of the experimental group was 87.50%,and the control group was 43.33% (P<0.05).The patients in two groups were of good tolerance in whole therapy and no severe side effects occured.The post-treatment VEGF level of the control group was (139.89±10.89)pg/mL,which was significantly lower than the pre-treatment (P＜0.05).The post-treatment VEGF level of experimental group was (81.57±4.71)pg/mL,significantly lower than pre-treatment (P<0.05).After treatment,the VEGF level of the experimental group was decreased significantly compared with the control group (P<0.05).Conclusion:Bevacizumab combined with chemotherapy in the treatment of advanced ovarian cancer with adhesive intestinal obstruction has a significant effect,can reduce VEGF level and with less adverse.