腹腔灌注联合静脉化疗与单纯静脉化疗对晚期卵巢上皮性癌的疗效  

Intravenous Chemotherapy alone or in Combination with Intraperitoneal Perfusion for Advanced Epithelial Ovarian Cancer

作　　者：邹果芳[1] 胡红波[1] 罗萍香[1] 何剑芬[1] 

机构地区：[1]汕头大学医学院附属韶关市粤北人民医院妇科,广东韶关512026

出　　处：《实用临床医学（江西）》2015年第5期46-49,共4页Practical Clinical Medicine

摘　　要：目的探讨腹腔灌注联合静脉化疗与单纯静脉化疗对晚期卵巢上皮性癌（简称卵巢癌）患者的疗效及不良反应。方法将76例晚期卵巢癌患者按用药方法的不同分为2组：联合化疗组（36例）和静脉化疗组（40例）。联合化疗组采用腹腔灌注加静脉联合化疗：第1天给予紫杉醇135mg·m^-2静脉滴注，于3h内输完；卡铂按血药浓度时间曲线下面积（AUC）计算取值6，于第2天腹腔给药，每3周1次为1个疗程。静脉化疗组采用单纯静脉化疗：第1天给予紫杉醇135mg·m^-2溶于500mL生理盐水中静脉滴注3h，间隔1h给予卡铂（按AUC计算取值6，溶于5％葡萄糖注射液500mL中）静脉滴注。每3周1次为1个疗程，共6～8次。观察患者生存期与临床、组织分期、化疗疗程关系；对2组患者血清CAl25水平变化、近期疗效及2、5年生存率进行比较。结果76例患者2年生存率为53．95％，5年生存率为34．21％。术后1年内化疗≥6个疗程的2年生存率为68．63％，06个疗程的2年生存率为24．00％，≥6个疗程的2年生存率明显高于06个疗程的2年生存率（X^2=13．45，P=0．001）。术后1年内化疗≥6个疗程的5年生存率为47．06％，06个疗程的5年生存率为8．00％，≥6个疗程的5年生存率明显高于06个疗程的5年生存率（X^2=11．37，P=0．001）。联合化疗组总有效率为66．7％，静脉化疗组总有效率为62．5％，2组比较差异无统计学意义（X^2=0．144，P〉0．05）。2组患者血清CAl25均有下降，联合化疗组总有效率为94．4％，静脉化疗组总有效率为90．0％，2组比较差异无统计学意义（X^2=0．515，P〉0．05）。联合化疗组血液系统毒性I-Ⅲ级发生率及消化系统反应I-Ⅲ级发生率分别为47．22％及72．22％，静脉化疗组分别为75．00％及90．00％。2组血液系统及消化系统不良反应发生率比较差异均有统计学意义（均P〈0．05）。结论晚期�ABSTRACT:Objective To explore the curative efficacies and adverse reactions of intravenous chemotherapy alone or in combination with intraperitoneal perfusion in the treatment of advanced epithelial ovarian cancer.Methods Seventy-six patients with advanced ovarian cancer were divid-ed into two groups according to administration methods.The combined chemotherapy group (n=36)was given intravenous drip of paclitaxel (135 mg·m-2 ,completion within 3 hours)on the first day,followed by intraperitoneal perfusion of carboplatin (AUC 6)on the second day.The in-travenous chemotherapy group (n=40)was given 3-hour intravenous drip of paclitaxel (135 mg·m-2 in 500 mL normal saline),followed by intravenous drip of carboplatin (AUC 6 in 500 mL 5% glu-cose injection)1 hour after paclitaxel treatment.The treatments were repeated 6-8 times once ev-ery 3 weeks.The relationships of survival time to clinical stage,pathological grade and chemother-apy cycles were observed in patients with advanced ovarian cancer.In addition,serum CA125 lev-els,short-term effects and 2-year and 5-year survival rates were compared between the two groups.Results The 2-year and 5-year survival rates were 53.95% and 34.21% in the 76 pa-tients,respectively.The 2-year and 5-year survival rates in patients who underwent postoperative chemotherapy≥6 cycles (68.63% and 47.06%,respectively)were significantly higher than those in patients who underwent postoperative chemotherapy<6 cycles (24.00% and 8.00%,respec-tively)(χ2 =13.45 andχ2 =11.37,respectively;P =0.001).There was no significant difference in the total effective rate between combined chemotherapy group and intravenous chemotherapy group (66.7% vs 62.5%,χ2 =0.144,P >0.05).Serum CA125 levels decreased after treatment in both groups,and the overall response rate was not obviously different between combined chemo-therapy group and intravenous chemotherapy group (94.4% vs 90.0%,χ2 =0.515,P >0.05). However,the incidences of gradeⅠ-Ⅲ hematological toxicity and gradeⅠ-Ⅲ gastrointestinal re-acti

关 键 词：卵巢癌 化疗 预后 

分 类 号：R737.31[医药卫生—肿瘤]