晚期(FIGO Ⅲ期、Ⅳ期)卵巢癌术前新辅助化疗可行性争议  

The Discussion of the Feasibility of Preoperative Neoadjuvant Chemotherapy in Advanced Ovarian Carcinoma(FIGO Stage Ⅲ and Ⅳ)

作　　者：陈良凤[1,2] 郑福利[1,3] 乔谷媛[1] 刘淑娟[1] 王建[1] 

机构地区：[1]第四军医大学西京医院妇产科,陕西西安710032 [2]安康市中心医院妇产科,陕西安康725000 [3]陕西中医学院第二附属医院妇产科,陕西咸阳712000

出　　处：《医学与哲学（B）》2014年第7期55-59,共5页Medicine & Philosophy(B)

基　　金：国家自然科学基金;项目编号:81172458/H1621;陕西省重点课题;项目编号:2012KTCL03-08

摘　　要：卵巢癌是女性生殖道恶性肿瘤致死率最高的肿瘤,尽管其发病率低于子宫颈癌及子宫内膜癌,但死亡率却位居首位。肿瘤细胞减灭术联合术后以铂类药物为主的化疗是目前卵巢癌的标准治疗方案。对晚期卵巢癌而言,满意的初次肿瘤细胞减灭术是非常重要而且必要的,但同时也存在诸多困难和挑战,常难以达到满意肿瘤减灭效果及合并严重手术并发症。为了增加晚期卵巢癌满意的初次肿瘤细胞减灭术的比率、减少手术并发症,近年来国内外采用术前新辅助化疗(NACT),借以改善晚期卵巢癌手术条件,提高满意肿瘤细胞减灭率。针对晚期卵巢癌的NACT目前尚存在许多争议,对于患者术后后续化疗的耐药性及5年存活率的改善等问题一直悬而未决。本文就晚期卵巢癌术前NACT可行性问题作一讨论。Ovarian cancer has the highest death rate in female genital tract tumors .Although its incidence is lower than that of cervical cancer and endometrial cancer ,the mortality rate is the highest .The present standard treatment plan for ovarian cancer is tumor cytoreductive surgery combined with postoperative platinum-based chemotherapy .In late stage ovarian cancer ,the optimal debulking is necessary .However ,debulking has its difficulties and challenges because there is a high probability of residual tumor and surgical complications .In order to increase the probability of optimal debulking and to reduce preoperative complications , the process of first neoadjuvant chemotherapy （NACT ） should be followed by debulking surgery ,and then chemotherapy again is introduced as a substitute process for primary surgery .Currently there is still a lot of debate regarding neoadjuvant chemotherapy for advanced ovarian cancer .NACT may improve conditions for advanced ovarian cancer surgery and increase the rate of cytoreductive .On the other hand ,NACT may increase drug resistance in postoperative follow-up chemotherapy and 5-year survival rate of patients treated with NACT is not significantly different from rate of patients with standard treatment . This article aims to discuss the feasibility of preoperative neoadjuvant chemotherapy in advanced ovarian carcinoma .

关 键 词：晚期卵巢恶性肿瘤 新辅助化疗 初次肿瘤细胞减灭术 

分 类 号：R711.75[医药卫生—妇产科学]