化学制剂分次给药对卵巢癌细胞种群恢复的影响及其在铂类耐药型复发卵巢癌患者中的疗效观察

发布时间：2018-10-10 20:38

【摘要】：目的：比较顺铂（Cisplatin，CDDP）与紫杉醇（Paclitaxel，PTX）不同的给药方案（单次或分次给药）对卵巢癌细胞SKOV3种群恢复的影响，并观察该两种细胞毒制剂分次给药对复发性铂类耐药及难治性卵巢癌患者的疗效。 方法：1.倒置显微镜观察CDDP和/或PTX单次或分次给药后对SKOV3细胞凋亡与种群恢复的影响；并用CCK-8法分别测定各处理组在第7天（D7）及D21的吸光度值（Optical density，OD）。2.对20例复发性铂类耐药和难治性卵巢癌患者进行CDDP90mg/m2分为D1, D2, D3+PTX175mg/m2分为D1, D8方案化疗，通过分析治疗前后患者症状、体征、影像学检查及CA125的变化情况，评估这部分患者对该方案的化疗反应性，探讨该方案的临床应用价值。 结果：11.1CDDP单次或分次给药对SKOV3的凋亡与种群恢复的影响无明显差异（F=70.421，p=0.970）；1.2单用PTX分次给药及CDDP联合PTX分次给药均较单次给药明显抑制SKOV3细胞的种群恢复（F=1872.275，p=0.000；F=1633.565，p=0.000），且其抑制作用在联合用药组中更明显（F=2500.464，p=0.000）。22.1观察20例复发性铂类耐药和难治性卵巢癌患者对CDDP90mg/m2分为D1, D2, D3+PTX175mg/m2分为D1, D8化疗方案的反应性，结果提示反应率为75%（15/20）,其中完全缓解率为25%（5/20）；2.2该方案主要的不良反应为骨髓抑制和胃肠道反应，积极对症处理的后，患者对此方案耐受性良好。 结论：细胞学实验结果提示CDDP联合PTX分次给药可明显抑制卵巢癌SKOV3细胞的种群恢复。临床中，，对于复发性铂类耐药和难治性卵巢癌患者，联合该两种药物分次给药获得较好反应性，但具体机理及对临床患者生存的改善需要进一步探讨和观察。
[Abstract]:Aim: to compare the effects of different regimen of cisplatin (Cisplatin,CDDP) and paclitaxel (Paclitaxel,PTX) on SKOV3 population recovery in ovarian cancer cells. The efficacy of the two cytotoxic agents in patients with recurrent platinum resistance and refractory ovarian cancer was observed. Method 1: 1. The effects of CDDP and / or PTX on apoptosis and population recovery of SKOV3 cells were observed by inverted microscope, and the absorbance values (Optical density,OD) of D7 and D21 were measured by CCK-8 method. Twenty patients with recurrent platinum-resistant and refractory ovarian cancer were treated with CDDP90mg/m2 as D _ 1, D _ 2, D _ 3 PTX175mg/m2 as D _ 1 and D _ 8 regimen chemotherapy. The changes of symptoms, signs, imaging examination and CA125 before and after treatment were analyzed. To evaluate the chemotherapeutic reactivity of these patients and to explore the clinical value of the regimen. Results: there was no significant difference in the effect of single or partial administration of 11.1CDDP on the apoptosis and population recovery of SKOV3 (FF70.421 P0. 970), 1.2 the single administration of PTX and CDDP combined with PTX significantly inhibited the population recovery of SKOV3 cells (FN 1872. 275 p0. 000). The inhibitory effect was more obvious in the combined treatment group than in the combination group. 22.1 the response of 20 patients with recurrent platinum-resistant and refractory ovarian cancer to CDDP90mg/m2 as D _ 1, D _ 2, D _ 3 PTX175mg/m2 divided into D _ 1 and D _ 8 was observed, and the inhibitory effect was more significant in the combination group (F _ (250) 0.464 (P _ (0.000), 22.1 the response of 20 patients with recurrent platinum resistance and refractory ovarian cancer to D1, D _ 2, D _ 3 PTX175mg/m2 was observed. The results showed that the response rate was 75% (15 / 20), and the complete remission rate was 25% (5 / 20), 2.2 the main adverse reactions of the regimen were bone marrow depression and gastrointestinal reaction. Conclusion: cytological results suggest that CDDP combined with PTX can significantly inhibit the population recovery of ovarian cancer SKOV3 cells. For patients with recurrent platinum resistance and refractory ovarian cancer, the combination of the two drugs can obtain better reactivity, but the specific mechanism and the improvement of the survival of the patients need to be further discussed and observed.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R737.31

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