Ⅱ～Ⅳ期上皮性卵巢癌术后化疗方案选择和疗程优化的探讨  

Selecting Postoperative Chemotherapy Regimen and Optimizing Therapy Cycle for Stage Ⅱ-Ⅳ Ovarian Epithelial Carcinoma

作　　者：黄永文[1] 李玉洁[1] 李孟达[1] 

机构地区：[1]中山大学肿瘤防治中心华南肿瘤学国家重点实验室,广东广州510060

出　　处：《癌症》2005年第8期994-997,共4页Chinese Journal of Cancer

摘　　要：背景与目的:上皮性卵巢癌的化疗方案和疗程目前仍有待优化和探讨。本研究通过回顾性病例分析以期寻求较为合适的卵巢癌术后化疗方案和疗程。方法:回顾性分析1986年1月至2000年12月在我科采用综合治疗的325例Ⅱ～Ⅳ期上皮性卵巢癌患者,对已治的Ⅱ～Ⅳ期上皮性卵巢癌患者的化疗方案及其疗程进行分析,比较不同化疗方案和疗程的临床疗效及对预后的影响。结果:采用HCBP、CP、CBP和CAP方案者5年生存率分别为84.3%、43.0%、46.1%和40.0%,四者比较有统计学意义(P=0.004);不同化疗方案的不良反应发生率分别为91.3%、76.0%、88.2%和87.7%(P=0.033)。化疗<5疗程、5～6疗程和>6疗程者5年生存率分别为35.1%、59.5%和56.2%,三者比较有统计学意义(P<0.001);而不良反应发生率分别为82.8%、81.1%和89.6%(P=0.214)。结论:Ⅱ～Ⅳ期上皮性卵巢癌患者采用CP为基础的化疗方案以及化疗疗程为5～6疗程较为合适。延长每疗程用药时间可获得较好的疗效。BACKGROUND ＆ OBJECTIVE. The postoperative chemotherapy for ovarian epithelial carcinoma need to be improved. This study was conducted to seek suitable chemotherapy for patients with stage Ⅱ-Ⅳ ovarian epithelial carcinoma. METHODS. The records of 325 patients with stage Ⅱ-Ⅳ ovarian epithelial carcinoma, received different postoperative chemotherapy （HCBP, CP, CBP, or CAP） regimens for different cycles from Jan. 1986 to Dec. 2000 in our cancer center, were analyzed retrospectively.The treatment outcome and prognosis of these patients were analyzed.RESULTS： The 5-year survival rate of the patients received HCBP regimen was significantly higher than those of the patients received CP, CBP, or CAP regimens （84.3% vs. 43.0%, P=0.008; 46.1%, P=0.016; and 40.0%, P=0.002）. The incidence of chemotherapy-related complications was significantly lower in the patients received CP regimen than in the patients received HCBP, CBP, or CAP regimens （76.0% vs. 91.3%, P=0.015; 88.2%, P=0.043; and 87.7%, P=0.038）. The 5-year survival rates of the patients received more than 6 or 5-6 cycles were significantly higher than that of the patients received less than 5 cycles （56.2% or 59.5% vs. 35.1%, P〈0.001）. The incidences of chemotherapy-related complications in such patients were 89.6%, 81.1%, and 82.8%（P=0.214）, respectively. CONCLUSIONS： We recommend 5-6 cycles of CP-based chemotherapy regimens for stage Ⅱ-Ⅳ ovarian epithelial carcinoma. Prolonging the duration of each chemotherapy cycle might achieve good prognosis.

关 键 词：卵巢肿瘤 癌 上皮性 药物疗法 联合 预后 并发症 

分 类 号：R737.31[医药卫生—肿瘤]