先期化疗在晚期卵巢癌的临床应用与疗效评价  

Clinical Application and Efficacy Evaluation of Adjuvant Chemotherapy in Advanced-stage Ovarian Cancer

作　　者：徐洁欢[1] 李新国[1] 曹兰琴[1] 黄乐[1] 

机构地区：[1]中南大学湘雅医院妇产科,湖南长沙410008

出　　处：《实用预防医学》2011年第3期466-468,共3页Practical Preventive Medicine

摘　　要：目的探讨先期化疗在治疗晚期卵巢癌中的临床意义和对预后的影响。方法分析我院52例Ⅲ、Ⅳ期卵巢癌患者,22例行先期化疗,然后进行中间肿瘤细胞减灭术及术后化疗(先期化疗组);30例行初次肿瘤细胞减灭术,再行术后化疗(对照组)。比较两组治疗的疗效及生存率。结果先期化疗组化疗有效率63.6%,胸腹水的控制率达89.5%,先期化疗组和对照组满意肿瘤减灭率分别为81.8%、36.7%,两组比较差异有统计学意义(P<0.005);先期化疗组术中出血量及手术时间较对照组少,两组比较差异均有统计学意义(P<0.05);先期化疗组术后并发症发生率13.6%,对照组术后并发症发生率20.0%,两组比较差异无统计学意义(P>0.05)。先期化疗组和对照组中位生存时间分别为35和24个月,两组间生存率比较,差异无统计学意义(P>0.05)。结论先期化疗能缩小瘤体,控制胸腹水,提高肿瘤细胞减灭率,特别对大量胸腹水、肿瘤体积较大和身体耐受差的患者疗效佳,但并未延长患者总的生存时间。Objective To explore the clinical value and the influence of prognosis of adjuvant chemotherapy in advanced-stage ovarian cancer. Methods Among 52 patients with Ⅲ or Ⅳ stage ovarian cancer,22 cases treated with adjuvant chemotherapy,middle-stage cytoreductive surgery followed and postoperative chemotherapy were served as NACT group,while the other 30 cases treated with primary cytoreductive surgery plus postoperative chemotherapy were served as control group.The curative effect and survival rate were compared between the two groups. Results The response rate of chemotherapy was 63.6% and the effective rate of extinguishing ascites was 89.5% in NACT group.The optimal surgery rate in NACT group was 81.8%,which was significantly higher than that in control group（36.7%,P〈0.005）.The amount of bleeding and time of operation in NACT group were less than those in control group,and the difference was statistically significant（P〈0.05）.The complication rate of NACT group was 13.6%,and that of control group was 20%.No statistically significant difference was found in the complication rate between the two groups（P〉0.05）.The median survival time of NACT group（35 months） was longer than that of control group（24 months）,there were no statistically significant differences between two groups in survival rate（P〉0.05）. Conclusions The adjuvant chemotherapy might decrease tumor size,control hydrothorax and improve the optimal surgery rate,especially for the patients with large pleural effusion,huge tumor and poor tolerance.But it can not prolong the patients＇ survival time in advanced ovarian cancer.

关 键 词：先期化疗 晚期卵巢癌 肿瘤细胞减灭术 疗效评价 

分 类 号：R737.31[医药卫生—肿瘤]