卵巢恶性生殖细胞肿瘤的治疗(附233例临床分析)  

Treatment of malignant germ cell tumors of the ovary: a clinical analysis of 233 cases

作　　者：张蓉[1] 洪婉君[1] 刘丽影[1] 李淑敏[1] 李凌[1] 张询[1] 

机构地区：[1]中国医学科学院中国协和医科大学肿瘤研究所肿瘤医院妇科

出　　处：《中华肿瘤杂志》1998年第2期155-157,共3页Chinese Journal of Oncology

摘　　要：目的探讨改进卵巢恶性生殖细胞肿瘤的治疗方法。方法回顾分析我院收治的２３３例卵巢恶性生殖细胞肿瘤。Ｉ期９４例，Ｉ～ＩＶ期４３例，复发转移９６例。单附件或全宫双附件加大网膜阑尾切除分别为７８例和１５１例，活检４例。单纯手术１７例，手术加放疗和化疗６５例，手术加化疗１５１例。结果全组存活１２７例，Ｉ期存活７８例，Ｉ～ＩＶ期１７例，复发转移３２例。总５年生存率为５５．６％。无性细胞肿瘤预后最好，５年生存率为８４．２％，非无性生殖细胞肿瘤为４４．６％，其中ＰＶＢ、ＢＥＰ方案化疗的生存率较高，为６６．０％和７３．３％。结论卵巢恶性生殖细胞肿瘤对化疗敏感，ＰＶＢ、ＢＥＰ是最有效的化疗方案。早期患者可治愈并保留生育功能；晚期先化疗，肿瘤局限后手术。Objective To evaluate the treatment methods of malignant germ cell tumors of the ovary. Methods Two hundred thirty three patients with malignant germ cell tumors of the ovary treated during1958 through 1993 were retrospectively analyzed.The number of patients in different stage of the disease was as follows: stage I,94; stage II～IV,43; recurrence or metastasis,96. Unilateral salpingo oophorectomy was performed in 78 patients, or total abdominal hysterectomy and bilateral salpingo oophorectomy with or without omentectomy and appendectomy was performed in 151 cases,and biopsy in 4 cases. Operation alone was done in 17 cases,operation plus radiotherapy with or without chemo therapy in 65, operation plus chemotherapy in 151 cases. Results Of the 233 patients 127 were disease free.The number of survivors in stage I patients was 78, in stage II～IV was17. There were 32 cases with recurrence and metastasis. The overall 5 year survival rate was 55.6%.The 5 year survival rate differed between dysgerminoma and nondysgerminomatous tumurs being 84.2% for the former and 44.6% for the latter.In patients with nondysgerminomatous tumors, chemotherapy with PVB and BEP regimens gave a 5 year survival rate of 66.0% and 73.3%, respectively. Conclusion Malignant germ cell tumors of the ovary is very sensitive to chemotherapy. The PVB and BEP regimens result in excellent response in these patients. Complete remission and preservation of fertility can be obtained in patients with early tumors. Preoperative chemotherapy and postoperative adjuvant chemotherapy can improve survival in patients with advanced tumors.

关 键 词：卵巢肿瘤 药物疗法 生殖细胞瘤 临床分析 

分 类 号：R737.310.5[医药卫生—肿瘤]