不同化疗方案治疗卵巢上皮性癌近期疗效及安全性的系统评价  

The system evaluation of safety and short-term effectiveness on treating ovarian epithelial cancer by different chemotherapy regimen

作　　者：燕纪林 白瑞云 李玉斌 

机构地区：[1]河北省张家口市建国医院妇产科,河北张家口075000

出　　处：《中国医药导报》2012年第9期77-79,共3页China Medical Herald

摘　　要：目的观察比较TC和PAC方案治疗上皮性卵巢癌的不良反应及近期疗效。方法对1999年1月～2005年10月收治的82例上皮性卵巢癌患者进行回顾性分析,随机分为手术加TC方案化疗(B组)与手术加PAC方案化疗(A组)两组,各41例。两组患者均行卵巢癌确定分期手术或较为满意的肿瘤细胞减灭术,且术后化疗次数在6次以上。41例患者手术加TC方案化疗(B组),41例患者手术加PAC方案化疗(A组),观察化疗后不良反应和近期疗效。结果 B组完成1～3个疗程者,有效率为35.29%;完成4～6个疗程者,有效率为63.64%;A组完成1～3个疗程者,有效率为23.08%。完成4～6个疗程者,有效率为60.71%。经χ2检验,两组的有效率差异无统计学意义(P>0.05);两组患者完成化疗治疗后进行临床缓解比较,B组CR+PR率明显高于A组,两组比较差异有统计学意义(χ2=4.017,P=0.026);B组5年生存率、中位生存期、PFI明显高于A组,两组比较差异有统计学意义(P<0.05);两组的不良反应为骨髓抑制、恶心呕吐,末梢神经毒性、肾功能损害、脱发等,两组方案在胃肠道反应、周围神经毒性和发热方面比较差异有统计学意义(P<0.05),其他毒性两组都存在,但TC方案较PAC方案轻。结论 TC方案及PAC方案在治疗上皮性卵巢癌中均有较好疗效;TC方案的毒性反应较PAC方案轻,如患者经济状况允许可作为上皮性卵巢癌术后化疗的一线用药。Objective To compare the short-term effectiveness and adverse reaction of treating ovarian epithelial cancer by TC and PAC regimen.Methods 82 patients with ovarian epithelial cancer were collected from Jan 1999 to Oct 2005 by retrospective analysis.They were divided randomly to PAC group（group A） and TC group（group B）,41 cases were in each.Both patients were all under treatment of surgery of ovarian cancer staging or satisfactory cytoreductive surgery,morever they were chemotherapied over six times.41 cases in group B were taken the regimen of operation plus TC,and then others in group A were applied in surgery plus PAC.The short-term effectiveness and adverse reaction were observed after chemotherapy.Results All the patients who accomplished less than 3 courses,the effective rate of the group B was 35.29% and that of the group A was 23.08%.In the patients who finished less than 6 courses,the effective rate of the group B was 63.64% and that of the group A was 60.71%.The rate of effective had no significant difference between the groups by Chi-square test（P 0.05）.CR＋PR of group B were remarkably higher than that of group A after chemotherapy,it had the significant difference（χ2 = 4.017,P = 0.026）.Also the 5-year durvival rate,median survival time and PFI of group B were all higher than that of group A（P 0.05）.The main adverse reactions were bone marrow inhibition,nausea and vomiting,peripheral neurotoxicity,renal impairment and hair loss,et al.There were statistical difference between two groups on gastrointestinal reaction,peripheral neurotoxicity and fever（P 0.05）,and the symptoms of other toxicity of TC regimen were milder than that of PAC.Conclusion Both TC and PAC regimen have the good curative effect.The toxic reactions of TC regimen are milder than that of PAC,and it can be considered as the first-line treatment for ovarian epithelial cancer if the economic conditions allows.

关 键 词：化疗方案 卵巢上皮性癌 TC方案 PAC方案 安全性 评价 

分 类 号：R737.31[医药卫生—肿瘤]