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作 者:蔡树模[1] 汤洁[1] 黄啸[1] 黄晓炜[1] 刘素萍[1]
机构地区:[1]复旦大学附属肿瘤医院妇瘤科,复旦大学上海医学院肿瘤学系,上海200032
出 处:《中国癌症杂志》2013年第12期980-983,共4页China Oncology
摘 要:背景与目的:卵巢上皮癌确诊时约70%以上属晚期,目前IIIC、Ⅳ期卵巢癌术后经一线标准化疗后,其5年无病生存率(diseasefreesurvival,DFS)约10%,本研究根据卵巢癌的特点,参考肿瘤细胞动力学和肿瘤药理学的原理,设计3步化疗法,以期提高III,、Ⅳ期卵巢癌患者5年DFS。方法:研究组(A组,n-15)给予3步化疗法(紫杉醇+卡铂,每3周给药1次,共6~8个周期;依托泊甙+环磷酰胺,每4周给药1次,共6个周期;卡铂+环磷酰胺,每8周给药1次,共6个周期)治疗,对照组(B组,n=51)回顾分析2007年复旦大学附属肿瘤医院妇瘤科收治的III,、Ⅳ期卵巢癌经标准一线化疗获临床缓解的患者(紫杉醇+卡铂,每3周给药1次,共6~8个周期),比较2组5年DFS。结果:A组5年DFS为80%(12/15),B组为5.9%(3/51),差异有统计学意义(P〈O.01)。结论:对III,、Ⅳ期卵巢癌在满意细胞减灭术后,采用3步化疗法能提高5年DFS。该方案疗效好,不良反应轻,治疗费用低,值得进一步开展临床研究。Background and purpose: More than 70 percent of ovarian cancer patients were diagnosed in the advanced stage. Currently the 5-year disease free survival (DFS) of stage IlI c-IV ovarian cancer patients wsa about 10 percent after first line chemotherapy. This study aimed to improve the 5-year DFS by three-step chemotherapy according to the mechanisms of ovarian cancer biological characteristics, cytodynamics and pharmacology. Methods: In arm A, the patients received three-step chemotherapy after primary debulking surgery, step one with paclitaxel plus carboplatin (TC regimen), every 3 weeks for 6 to 8 cycles; step two with etoposide plus cyclophosphamide, every 4 weeks for 6 cycles; step three wit carboplatin plus cyclophosphamide every eight weeks for six cycles. In control arm B, we retrospectively analysed 51 cases with 1 c-IV stage ovarian cancer, who had completely response after standard chemotherapy with six to eight cycles of TC after primary surgery during 2007. We compared the 5-year DFS between the two arms. Results: The 5-year DFS of 15 cases in arm A was 80%(12/15), which was significantly higher than that of arm B (5.9%, 3/51, P〈0.01). Conclusion: The three-step chemotherapy after optimal debulking surgery in stage IIIc-IV can improve the 5-year DFS. This regimen is high efficacy, mild side-effect witn low cost, which deserves further exploration.
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