间歇性肿瘤细胞减灭术与初始肿瘤细胞减灭术对晚期上皮性卵巢癌的疗效评价  

Evaluation of the efficacy of interval debulking surgery and primary debulking surgery on advanced epithelial ovarian cancer

作　　者：张圆圆[1] 候晓东 张楚珺 王志伟 ZHANG Yuanyuan;HOU Xiaodong;ZHANG Chujun;WANG Zhiwei(Department of Gynecology,the First Affiliated Hospital of He’nan University,Kaifeng 475000,He’nan,China;Department of Ultrasonography,the First Affiliated Hospital of He’nan University,Kaifeng 475000,He’nan,China;Department of Oncology,the First Affiliated Hospital of He’nan University,Kaifeng 475000,He’nan,China)

机构地区：[1]河南大学第一附属医院妇科,河南开封4750000 [2]河南大学第一附属医院超声科,河南开封4750000 [3]河南大学第一附属医院肿瘤科,河南开封4750000

出　　处：《癌症进展》2020年第5期493-495,508,共4页Oncology Progress

基　　金：河南省医学科技攻关计划项目(201602161)。

摘　　要：目的探讨间歇性肿瘤细胞减灭术(IDS)与初始肿瘤细胞减灭术(PDS)对晚期上皮性卵巢癌(EOC)的疗效。方法根据手术方法的不同将132例晚期EOC患者分为PDS组(n=87例)和IDS组(n=45)。PDS组患者行PDS手术后接受6~8个疗程的化疗。IDS组患者行PDS手术后接受3个疗程的化疗,然后再行IDS手术后化疗3~5个疗程。观察两组患者的PDS切除范围,比较两组患者的减瘤满意率、疗效、血清CA125水平和不良反应发生情况。结果IDS组患者的PDS切除范围明显小于PDS组(P﹤0.01)。IDS组患者的减瘤满意率高于PDS组(P﹤0.05)。IDS组患者的临床疗效明显优于PDS组(P﹤0.01)。术前和第3次化疗后,两组患者的血清CA125水平比较,差异均无统计学意义(P﹥0.05)。IDS组患者PDS后的血清CA125水平高于PDS组,完成化疗后的血清CA125水平低于PDS组(P﹤0.05)。IDS组患者的不良反应总发生率低于PDS组(P﹤0.05)。结论IDS有助于提高晚期EOC患者的手术减瘤满意率和近期疗效,且不会显著增加不良反应。Objective To investigate the efficacy of interval debulking surgery(IDS)and primary debulking surgery(PDS)in the treatment of advanced epithelial ovarian cancer(EOC).Method According to the different surgical methods,132 patients with advanced EOC were divided into PDS group(n=87)and IDS group(n=45).The PDS group received 6~8 cycles of chemotherapy after PDS operation,and the IDS group had 3 cycles of chemotherapy after IDS management,and another 3~5 cycles of chemotherapy after a second IDS operation.The excised volume during PDS,satisfaction rate of tumor reduction,curative effect,serum CA125 level and incidence of adverse reactions were compared between the two groups.Result Less volume of excision during PDS was noted in IDS group than in PDS group(P<0.01).The satisfaction rate of tumor reduction in IDS group was higher than that in PDS group(P<0.05).Generally improved clinical efficacy was demonstrated in IDS group versus PDS group(P<0.01).There was no significant difference with respect to the serum CA125 levels between the two groups before chemotherapy and after the third chemotherapy(P>0.05).After PDS,serum CA125 in IDS group was higher than that in PDS group(P<0.05),while it was lower than that in PDS group after completing chemotherapy(P<0.05).The overall incidence of adverse reactions in IDS group was lower than that in PDS group(P<0.05).Conclusion IDS is conducive to improving the satisfaction rate of tumor reduction and short-term efficacy of patients with advanced epithelial ovarian cancer,without significant increase of adverse reactions.

关 键 词：晚期上皮性卵巢癌 间歇性肿瘤细胞减灭术 初始肿瘤细胞减灭术 疗效 不良反应 

分 类 号：R737.31[医药卫生—肿瘤]