初始化疗或手术对Ⅲ期卵巢癌的临床疗效分析  

Clinical Effects of Different Initial Therapies on Stage Ⅲ Ovarian Cancer

作　　者：冯仙明[1] 陈焕伟[1] 王博[1] 陈艳[1] 梁锦辉[1] 

机构地区：[1]广东省农垦中心医院/湛江肿瘤医院,广东湛江524002

出　　处：《肿瘤药学》2016年第5期375-378,共4页Anti-Tumor Pharmacy

摘　　要：目的研究初始化疗或初始手术治疗对Ⅲ期卵巢癌的临床疗效。方法选取我院2013年1月~2014年1月收治的96例Ⅲ期卵巢癌患者,并根据初始治疗方案的不同分为初始化疗组48例、初始手术组48例。初始化疗组使用紫杉醇和顺铂（TP方案）行辅助化疗,后行间隔减瘤术及术后化疗;初始手术组临床施行肿瘤细胞减灭术,后使用紫杉醇和顺铂（TP方案）进行术后化疗。观察和比较两组患者的治疗效果、手术情况以及疾病的复发情况。结果初始手术组临床有效率为52.1%,初始化疗组为66.7%,差异无统计学意义（P〉0.05）;初始化疗组患者术中腹水量少于初始手术组,满意减瘤率明显高于初始手术组,术后并发症的发生率低于初始手术组,差异均有统计学意义（P〈0.05）,但两组患者的术前KPS评分相似,差异无统计学意义（P〉0.05）;初始手术组复发率为56.3%,2年生存率为70.83%,初始化疗组复发率为29.2%,2年生存率为89.58%,初始手术组复发率较初始化疗组显著升高,生存率显著下降,差异有统计学意义（P〈0.05）。结论临床对Ⅲ期卵巢癌患者采取先行化疗后进行肿瘤细胞减灭术,患者肿瘤控制效果好,且腹水明显减少,满意减瘤率提高,手术并发症发生率降低,疾病复发率降低,提高了患者生存率。Objective To study the clinical effects of initial chemotherapy or initial surgery on patients with stage Ⅲ ovarian cancer and explore its impact on interval debulking surgery. Methods We collected the clinical data of 96 patients with stage Ⅲ ovarian cancer who were treated between January 2013 and January 2014 in our hospital. The subjects were divided into the chemotherapy group （48 cases） and operation group （48 cases） according to their initial therapy. Patients in chemotherapy group initially received the adjuvant chemotherapy of Paclitaxel and DDP （TP）, and then interval debulking surgery and postoperative chemotherapy. Patients in operation group initially received the interval debulking surgery and then adjuvant chemotherapy of Paclitaxel and DDP （TP）. We observed and compared the clinical ef- fects, operation circumstance as well as the recurrence rate after 2-year follow-up between the two groups. Results The clinical effective rate of operation group （52.1%） was lower than that of chemotherapy group （66.7%）. There were no significant differences between the two groups （P 〉 0.05）. Patients in chemotherapy group had less intra-operative ascites, and higher satisfactory rate for interval debulking surgery than those in operation group （P〈0.05）. They also had lower incidence rate of postoperative complications than patients in operation group （P〈 0.05）. The preoperative KPS scores were similar in two groups of patients, and had no significant differences （P 〉 0.05）. In addition, the recurrence rate of operation group （56.3%） was higher than that of chemotherapy group （29.2%） （P〈 0.05）, and the 2-year survival rate of operation group （70.83%） was lower than that of chemotherapy group （89.58%） （P〈 0.05）. Conclusion The initial chemotherapy combined with interval debulking surgery had better effects on patients with stage III ovarian cancer. It could improve the survival rate and satisfactory rate for interval debulking surgery,

关 键 词：新辅助化疗 复发因素 疗效评价 Ⅲ期卵巢癌 肿瘤细胞减灭术 

分 类 号：R737.31[医药卫生—肿瘤]