新辅助化疗联合间歇性肿瘤细胞减灭治疗晚期卵巢癌的效果及总生存期的影响因素分析  

Efficacy of neoadjuvant chemotherapy combined with intermittent tumor cell subtraction in the treatment of advanced ovarian cancer patients and risk factors affecting overall survival

作　　者：陈会晓[1] 张凤丽[1] 刘雪崴 杜静[1] 王斌[1] 庄献鹏 Chen Huixiao;Zhang Fengli;Liu Xuewei;Du;ling;Wang Bin;Zhuang Xianpeng(Department of Obstetrics and Gynecology, Liaocheng People＇s Hospital, Liaocheng 252000, Chin;Department of Obstetrics and Gynecology, Liaocheng Mechanical and Electronic Hospital, Liaocheng 252000, China;CT Room, Liaocheng Fourth People＇s Hospital, Liaocheng 252000, Chin)

机构地区：[1]山东省聊城市人民医院妇产科,252000 [2]山东省聊城市机械电子医院妇产科,252000 [3]山东省聊城市第四人民医院CT室,252000

出　　处：《中国实用医刊》2018年第12期50-53,56,共5页Chinese Journal of Practical Medicine

摘　　要：目的探讨新辅助化疗联合间歇性肿瘤细胞减灭术对晚期卵巢癌患者的治疗效果，评估影响患者总生存期的危险因素。方法回顾分析2009年6月至2015年12月来医院就诊的晚期卵巢癌患者423例的临床资料，根据治疗方式不同分为对照组（初次肿瘤细胞减灭术联合化疗，PDS组）228例和观察组（新辅助化疗联合间歇性肿瘤细胞减灭术，IDS组）195例。比较两组患者的一般情况、手术情况、疗效及总生存期（OS）和无进展生存期（PFS）。采用多因素分析方法探讨影响晚期卵巢癌患者预后的独立危险因素。结果（1）IDS组患者的满意缩瘤率（72．82％）明显高于PDS组患者（60．96％，P〈0．05），IDS组无肉眼残留病灶的比例（7．18％）也明显大于PDS组（3．95％，P〈0．05）。（2）IDS组患者手术时间、术中出血量及输血量、术后住院时间明显少于PDS组患者（P〈0．05）。（3）IDS组患者治疗总有效率（62．05％）明显高于PDS组患者（49．56％，P〈0．05）。（4）IDS组患者PFS和OS均长于PDS组，但差异未见统计学意义（P〉0．05）。（5）FIGO分期Ⅲ～Ⅳ期、病理G2级、最大肿瘤直径〉10cm及残余肿瘤直径〈1cm是影响患者预后的独立危险因素（P〈0．05）。结论新辅助化疗联合间歇性肿瘤细胞减灭术能够明显提高晚期卵巢癌治疗的满意缩瘤率，减少手术时间、术中出血量及输血量，提高治疗有效率，但是不能提高患者的PFS和OS。患者的临床分期、病理分级、最大原发肿瘤直径和残余瘤体积可能对患者选择治疗方案提供帮助。Objective To investigate the efficacy of neoadjuvant chemotherapy combined with intermittent tumor cell subtraction in the treatment of advanced ovarian cancer patients and analyze the risk factors affecting overall survival. Methods The data of 423 patients with advanced ovarian cancer from June 2009 to December 2015 were retrospectively reviewed. The patients were divided into two groups according their therapeutic regien, which included PDS group （ n = 228, those who received primary debulking surgery combined with regular chemotherapy） and IDS group （n = 195, those who received neoadjuvant chemotherapy combined with interval debulking surgery）. The general conditions, operation conditions, Curative effect, total survival and disease-free survival period were compared between the two groups. Exploiting multivariate analysis to investigate risk factors affecting the prognosis of ovarian cancer patients. Results （1）The optimal debulking rate of IDS group （72. 82% ） was much higher than PDS group （60.96%, P 〈 0.05 ）. The rate of the residual lesion of naked eyes of IDS group （7.18%） was also higher than PDS group （3.95%, P 〈 0.05）. （2）The total time, bleeding volume,transfusion volume during operation and post operation hospitalization duration of IDS group was smaller than PDS group （P 〈 0.05 ）. （3）The total therapeutic efficacy of IDS group （62. 05 % ） was higher than PDS group （49.56% , P 〈0.05）. （4）Both of OS and PFS of IDS group were longer than PDS group, but there were no statistically differences between them （P 〉 0.05 ）. （5）The clinical stage FIGO Ⅲ/Ⅳ, pathological G2 grade, maximum tumor diameter more than 10 cm and residual tumor diameter less than 1 cm were independent risk factors affecting the prognosis of patients. Conclusions Neoadjuvant chemotherapy combined with intermittent tumor cell subtraction significantly increases the tumor reduction rate of advanced ovarian tumor, decreases total operation time, bleeding volume and

关 键 词：新辅助化疗 肿瘤细胞减灭术 卵巢癌 

分 类 号：R737.31[医药卫生—肿瘤]