MACT联合IDS治疗晚期卵巢上皮细胞癌的预后获益及影响因素分析  

Analysis of Prognostic Benefit and Influencing Factors of NACT Combined with IDS in the Treatment of Advanced Ovarian Epithelial Cell Carcinoma

作　　者：沈需 吕卫琴 尚云 马睿 柴馨婷 SHEN Xu;LV Weiqin;SHANG Yun;MA Rui;CHAI Xinting(Department of Oncology,Yuncheng Central Hospital,Yuncheng Shanxi 044000,China)

机构地区：[1]运城市中心医院肿瘤科,山西运城044000

出　　处：《中国医疗设备》2023年第3期131-137,共7页China Medical Devices

基　　金：山西省卫生健康委科研课题计划(2018156)。

摘　　要：目的探讨新辅助化疗(Neoadjuvant Chemotherapy,NACT)联合间歇性肿瘤细胞灭减术(Interval Debulking Surgery,IDS)对晚期卵巢上皮细胞癌患者预后获益以及相关影响因素。方法回顾性分析2015年1月至2019年1月于我院行初次肿瘤细胞减灭术(Primary Debulking Surgery,PDS)和NACT联合IDS治疗的102例晚期卵巢上皮细胞癌患者的临床资料并进行生存随访。对影响患者预后的各项因素进行单因素、多因素和生存曲线分析。结果PDS组患者的中位无进展生存期(Progression-Free Survival,PFS)为15.2个月,NACT+IDS组患者的PFS为9.1个月,两组患者PFS差异具有统计学意义(P<0.05)。经单因素和Cox多因素分析,患者术后开始化疗时间、术后残留灶大小和体质指数是NACT+IDS组患者PFS的独立影响因素(P<0.05)。患者术后残留病灶大小、IDS前血清糖类抗原125(Carbohydrate Antigen 125,CA125)水平和手术病理分期是NACT+IDS组患者总生存期(Overall Survival,OS)的独立影响因素(P<0.05)。NACT+IDS组患者的不同术后残留灶大小、IDS前血清CA125水平是否正常以及Ⅲc期和Ⅳ期的中位OS比较差异存在统计学意义(P<0.05)。进行IDS后开始化疗时间是NACT+IDS组患者PFS的独立影响因素,IDS前血清CA125水平正常与否是NACT+IDS组患者OS的独立影响因素(P<0.05)。结论NACT+IDS组患者术后残留病灶大小、IDS前血清CA125水平和手术病理分期是NACT+IDS组患者PFS和OS的独立影响因素,对患者IDS前血清CA125水平进行检测并使其降低至正常水平,且在术后患者加强IDS围手术期管理,能够改善晚期卵巢上皮细胞癌患者预后。Objective To explore the prognostic benefits and influencing factors of neoadjuvant chemotherapy(NACT)combined with interval debulking surgery(IDS)in patients with advanced ovarian epithelial cell carcinoma.Methods Clinical data of 102 patients with advanced ovarian epithelial cell carcinoma who underwent primary debulking surgery(PDS)and NACT combined with IDS in our hospital from January 2015 to January 2019 were analyzed retrospectively.Inpatient data were collected and survival follow-up was performed.Univariate,multivariate and survival curve analysis were performed on the factors affecting the prognosis of patients.Results The median progression-free survival(PFS)of the PDS group was 15.2 months,and that of the NACT+IDS group was 9.1 months,the difference in PFS between the two groups was statistically significant(P<0.05).Univariate analysis and Cox multivariate analysis showed that the time of postoperative chemotherapy initiation,postoperative residual lesion size and body mass index were independent influencing factors of PFS in the NACT+IDS group(P<0.05).Postoperative residual lesion size,pre-IDS serum carbohydrate antigen 125(CA125)level and surgical pathological stage were independent factors influencing overall survival(OS)of patients in NACT+IDS group(P<0.05).There were statistically significant differences in the size of postoperative residual lesions,the normal level of serum CA125 before IDS and the median OS between stageⅢc and stageⅣin NACT+IDS group(P<0.05).The time of postoperative chemotherapy initiation after IDS treatment was an independent influencing factor for PFS in the NACT+IDS group,and the normal level of serum CA125 before IDS was an independent influencing factor for OS in the NACT+IDS group(P<0.05).Conclusion Postoperative residual lesion size,pre-IDS serum CA125 level and surgical pathological stage in patients with NACT+IDS are independent influencing factors of PFS and OS in patients with NACT+IDS group.The pre-IDS serum CA125 level is detected and reduced to normal level,

关 键 词：新辅助化疗 间歇性肿瘤细胞灭减术 晚期卵巢上皮细胞癌 血清CA125水平 

分 类 号：R737.31[医药卫生—肿瘤]