紫杉醇和顺铂静脉化疗结合腹腔化疗对晚期上皮性卵巢癌的疗效观察  

Efficacy of intraperitoneal perfusion with paclitaxel and cisplatin combined with intraperitoneal chemotherapy for advanced ovarian epithelial cancer

作　　者：赵敏[1] 李伟哲 刘小红[1] ZHAO Min;LI Wei-zhe;LIU Xiao-hong(Department of Obstetrics and Gynecology,Shaanxi Armed Police Corps Hospital,Xi'an 710054,China;School of Medicine,Xi'an Jiaotong University,Xi'an 710054,China)

机构地区：[1]武警陕西总队医院妇产科,西安710054 [2]陕西省西安交通大学医学部,西安710054

出　　处：《中国肿瘤临床与康复》2021年第8期937-940,共4页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨紫杉醇与顺铂(TP方案)联合静脉化疗结合腹腔化疗对晚期上皮性卵巢癌(EOC)的临床疗效及对血清Dickkopf-2(DKK-2)和第二线粒体caspase激活蛋白(Smac)表达的影响。方法选取2012年6月至2014年6月间武警陕西总队医院收治的116例EOC患者,根据化疗方法不同进行分组,采用TP方案静脉化疗治疗的58例患者纳入对照组,采用TP静脉化疗联合紫杉醇腹腔灌注化疗的58例患者纳入观察组,比较两组患者的近期疗效、治疗前后的血清DDK-2和Smac水平,以及两组患者的不良反应和3年生存率。结果观察组患者总有效率为79.3%,高于对照组的60.3%,差异有统计学意义(P<0.05)。治疗后,观察组患者血清DK-2和Smac水平高于对照组,差异均有统计学意义(均P<0.05)。观察组患者骨髓抑制发生率高于对照组,差异有统计学意义(P<0.05)。两组随访期间均失访1例,观察组患者3年生存率为61.4%(35/57),高于对照组的40.4%(23/57),差异有统计学意义(P<0.05)。结论TP方案静脉化疗结合腹腔灌注化疗能有效提高晚期EOC患者的近期和远期疗效,上调血清DDK-2和Smac水平,但会增加骨髓抑制风险,化疗前建议进行相应预防治疗。Objective To analyze the clinical efficacy of intraperitoneal perfusion with paclitaxel and cisplatin(TP regimen)combined with intraperitoneal chemotherapy in the treatment of advanced ovarian epithelial cancer and the effects on serum Dickkopf-2(DDK-2)and second mitochondria-derived activator of caspase(Smac).Methods A total of 116 patients with advanced ovarian epithelial cancer were selected at Shaanxi Armed Police Corps Hospital and were randomly divided into an observation group and a control group with 58 patients in each group.The observation group received intraperitoneal perfusion with TP regimen combined with intraperitoneal chemotherapy and the control group received intraperitoneal perfusion with TP scheme.After 3 courses,the short-term efficacy and the serum DDK-2 and Smac,the adverse reactions and 3-year survival were compared between the two groups.Results The overall clinical efficacy was 79.3%in the observation group,which was significantly higher than 60.3%of the control group(P<0.05).After the treatment,the serum DKK-2 and Smac were significantly higher in observation group than in the control group(all P<0.05).The incidence of myelosuppression was significantly higher in the observation group than in the control group(P<0.05).The two groups each had 1 patient lost to follow-up.The 3-year survival rate was 61.4%(35/57)in the observation group which was significantly higher than 40.4%(23/57)in the control group(P<0.05).Conclusion Intraperitoneal perfusion with TP scheme combined with intravenous chemotherapy can effectively increase the short-and long-term efficacy,up-regulate serum DDK-2 and Smac and increase the risk of myelosuppression.Preventive treatments are recommended before chemotherapy.

关 键 词：紫杉醇 顺铂 上皮性卵巢肿瘤 Dickkopf-2 第二线粒体caspase激活蛋白 骨髓抑制 

分 类 号：R737.31[医药卫生—肿瘤]