重组人血管内皮抑制素联合多西他赛和顺铂方案新辅助化疗治疗晚期上皮性卵巢癌的临床疗效观察  

Clinical research of neoadjuvant chemotherapy of endostar combined with TP for patients with advanced ovarian cancer

作　　者：李苏霞[1] 林蓓蓓[1] 陈素秀[1] Li Suxia;Lin Beibei;Chen Suxiu(Department of General Medicine, the First Affiliated Hospital ofWenzhou Medical University, Wenzhou 325000, Chin)

机构地区：[1]浙江省温州医科大学附属第一医院全科医学科,温州325000

出　　处：《中华内分泌外科杂志》2018年第2期158-162,共5页Chinese Journal of Endocrine Surgery

摘　　要：目的探讨重组人血管内皮抑制素（endostatin，ES）联合多西他赛和顺铂方案新辅助化疗治疗晚期上皮性卵巢癌的临床疗效。方法将2012年4月至2014年4月浙江温州医科大学附属第一医院的晚期卵巢癌患者76例用随机数字表法分为观察组和对照组，术前均行新辅助化疗，对照组采用多西他赛和顺铂（TP）方案，观察组采用ES联合TP方案。比较2组临床疗效、手术及远期生存情况。结果所有研究对象均顺利完成3个周期化疗，观察组白细胞下降程度、食欲减退、发热发生率均高于对照组，2组比较差异有统计学意义（P〈0．05）；所有研究对象在化疗后CA125、肿瘤负荷和腹腔积液深度均出现明显下降，化疗前后差异均有统计学意义（P〈0．05）；2组在术中腹水量、出血量、手术时间、住院天数比较差异无统计学意义（P〉0．05）。观察组残留病灶大小≤2cm占比为84．2％，明显高于对照组的60．5％，且2者差异有统计学意义（P〈0．05）。对照组和观察组1、3年总生存率分别为84．2％、63．1％和86．8、60．5％；2组总生存率差异无统计学意义（γ2=0．207，P=0．649），对照组和观察组1、3年无疾病进展生存时间分别为89．4％、68．4％和94．7％、76.3％，2组无疾病进展生存率比较差异有统计学意义（γ2=4．042，P=0．040）。结论ES联合TP方案治疗晚期卵巢癌是安全有效的。可提高肿瘤减灭术切净率，提高肿瘤局部控制率。Objective To explore the clinical effect of neoadjuvant chemotherapy of endostar combined with docetaxel plus cisplatin（TP） on patients with advanced ovarian cancer. Methods 76 patients meeting the crite- rion were enrolled to the study, and they were randomly divided into study group and the control group. The con- trol group were administered with TP, while the study group received endostar combined with TP. The clinical ef- fects, conditions of surgery and long-term survival were observed. Results All patients finished 3 cycles of neoadjuvant chemotherapy. The incidence of adverse reactions （leucopenia, anorexia and fever） in the study group was higher than that in the control group, and the difference had statistical significance （P〈0.05）. The level of CA- 125, tumor load and ascites volume decreased after chemotherapy （P〈0.05）. The two groups had no significance difference in intraoperative ascites, blood loss, time of surgery or hospital stay （P〉0.05）. The rate of residual lesions〈2 cm was 84.2% in the study group, higher than that of the control group （60.5%）, and the difference had statistical significance （P〈0.05）.The overall 1-year and 3-year survival were 84.2%, and 63.1% for the control group, 86.8% and 60.5% for the study group, and the difference had no statistical significance （χ2=0.207,P=0.649）. One-year and 3-year disease free survival were 89.4% and 68.4% for the control group, 94.7% and 76.3% for the study group （χ2=4.042,P=0.040）. Conclusion Endostar combined with TP （docetaxel plus cisplatin） for patients with advanced ovarian cancer is safe and effective, which can improve the success rate of cytoreductive surgery and local control rate of tumor.

关 键 词：晚期卵巢癌 重组人血管内皮抑制素 新辅助化疗 预后 

分 类 号：R737.31[医药卫生—肿瘤]