新辅助化疗联合间隔减瘤术在晚期卵巢癌中的临床应用研究  

Clinical application research of neoadjuvant chemotherapy followed by interval debulking surgery in advanced epithelial ovarian cancer patients

作　　者：李菁[1] 沈立翡[1] 朱岚[1] 蔡蕾[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院妇产科,上海200025

出　　处：《中国计划生育和妇产科》2015年第11期53-57,共5页Chinese Journal of Family Planning & Gynecotokology

摘　　要：目的探讨新辅助化疗联合间隔减瘤术(neoadjuvant chemotherapy followed by interval debulking surgery,NACT/IDS)在晚期卵巢癌中的临床应用价值。方法回顾性分析上海交通大学附属瑞金医院2000年6月至2013年1月109例IIIc和IV期晚期卵巢癌患者资料,将53例直接行肿瘤减灭术(primary debulking surgery,PDS)患者纳入PDS组,将56例行NACT/IDS患者纳入NACT/IDS组,比较两组的生存率及围手术期情况。结果两组患者术后总生存率(overall survival,OS)和无病进展期(progression-free survival,PFS)比较差异均无统计学意义(P>0.05)。NACT/IDS组手术切除率(53.6%)明显高于PDS组(43.4%)(P<0.05);NACT/IDS组手术出血量、术后恢复、并发症的发生情况优于PDS组(P<0.05)。结论 NACT/IDS增加了手术切除率,减少了手术创伤,术后生存率与PDS无明显差异。在Ⅲc期和Ⅳ期卵巢癌患者,并非强调直接行PDS,NACT/IDS是有效的治疗方法。Objective To explore the application value of neoadjuvant chemotherapy followed by interval debulking surgery （NAC/IDS） in treating patients with advanced epithelial ovarian cancer （EOC）. Methods We retrospectively reviewed 109 patients with stage IIIC or IV EOC treated at Ru^iin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from June 2000 to January 2013. 53 patients underwent PDS were selected into PDS group, while 56 patients underwent NAC/IDS were selected into NAC/IDS group, the survival rate and perioperative morbidity were compared between two groups. Results No difference in overall survival （OS） or progression -free survival （PFS） were observed between NAC/IDS group and PDS group （P 〉 0. 05 ）. The optimal debulking rate of NAC/IDS group （53.6 % ） was significantly higher than that of the PDS group （43.4 % ） （P 〈0. 05 ）. The NAC/ IDS group had significantly less intraoperative blood loss, lower complication rate, and earlier recovery compared to PDS group （ P 〈 0. 05 ）. Conclusion NAC/IDS may increase the resection rate and reduce the surgical trauma, without significantly difference in survival rate compared with PDS. NAC/IDS may be a valuable alternative treatment for patients with stage IIIC or IV EOC.

关 键 词：上皮性卵巢恶性肿瘤 间隔减瘤术 新辅助化疗 直接肿瘤减灭术 

分 类 号：R737.31[医药卫生—肿瘤]