晚期上皮性卵巢癌不同治疗方案的预后影响因素分析  

Prognostic Factors for Different Treatment Regimens in Advanced Epithelial Ovarian Cancer

作　　者：刘传忠[1] 王鹤[1] 蔡志福[1] 赵冰冰[1] 李力[1] LIU Chuanzhong;WANG He;CAI Zhifu;ZHAO Bingbing;LI Li(Department of Gynecologic Oncology,Affiliated Tumor Hospital of Guangxi Medical University,Key Laboratory of Ministry of Education for Early Prevention and Treatment of Regional High-incidence Tumor,Nanning 530021,China)

机构地区：[1]广西医科大学附属肿瘤医院妇瘤科、区域性高发肿瘤早期防治研究教育部重点室验室,南宁530021

出　　处：《肿瘤防治研究》2018年第10期746-751,共6页Cancer Research on Prevention and Treatment

基　　金：广西科学研究与技术开发计划项目(桂科攻1140003A-33,桂科攻1140003A-34)

摘　　要：目的分析晚期上皮性卵巢癌患者接受传统治疗及新辅助化疗的预后差异,探讨影响患者预后的临床特征。方法回顾性分析129例晚期上皮性卵巢癌患者临床资料。根据不同治疗方案分为NACT-IDS组(69例)及PDS组(60例)。结果两组患者平均手术时间、术中出血量、手术并发症的发生率及术后住院日差异均无统计学意义(P>0.05)。NACT-IDS组及PDS组手术理想减灭率差异有统计学意义(P=0.002)。两组患者平均总生存期及无进展生存期差异均无统计学意义。根据年龄、临床分期、病理学类型等临床特征单独比较接受不同治疗方案的两组患者预后,发现差异均无统计学意义(P>0.05)。将临床特征组合进行评估时,仅接受NACT-IDS及PDS治疗并达到理想减灭的Ⅲ期患者平均总生存时间差异有统计学意义(P=0.030)。结论对于晚期上皮性卵巢癌,建议经评估可以通过PDS达到理想减灭的Ⅲ期患者行PDS,其余晚期患者可以放宽NACT的实施标准。Objective To compare the clinical efficacy of patients with advanced epithelial ovarian cancer（AEOC） treated by primary debulking surgery（PDS） and neoadjuvant chemotherapy（NACT）,and to explore the clinical characteristics of patients with different prognosis. Methods We analyzed retrospectively the clinical data of 129 AEOC patients. Patients were divided into neoadjuvant chemotherapy and interval debulking surgery（NACT-IDS） group（n=69） and PDS group（n=60） according to the treatment regimen. Results There was no significant difference in the average operative time, blood loss, incidence of complications or postoperative hospital stay between NACT-IDS group and PDS group（P〉0.05）. The rate of optimal debulking for NACT-IDS group and PDS group were 82.6% and 58.3%（P=0.002）. There was no significant difference in the OS and PFS between two groups. Taken age, clinical stage and pathologic type as the distinguishing criteria alone, there was no significant difference in the prognosis between two groups（P〉0.05）. When we analyzed these clinical characteristics in combination, the OS only had a statistically significant differencewhen patients with stage Ⅲ reached the goal of optimal debulking between two groups（P=0.030）. Conclusion For patients with advanced epithelial ovarian cancer, PDS is recommended for patients with stage Ⅲ who can reach the goal of optimal debulking via PDS after evaluation, and the NACT implementation standards could be relaxed for other patients.

关 键 词：晚期上皮性卵巢癌 新辅助化疗 预后 

分 类 号：R737.31[医药卫生—肿瘤]