摘要
目的探究晚期上皮性卵巢癌患者新辅助化疗的治疗效果及预后影响因素。方法回顾性分析126例晚期上皮性卵巢癌患者的临床资料，按治疗方法分为新辅助化疗＋间歇性肿瘤细胞减灭术组（IDS组，66例）和初始肿瘤细胞减灭术＋术后化疗组（PDS组，60例）。比较两组患者的基线资料特征、疗效、预后情况、手术情况及术后并发症发生情况等，分析晚期上皮性卵巢癌患者预后的影响因素。结果IDS组及PDS组治疗总有效率分别为68.2%和76.7%，复发率分别为62.2%和63.0%，两组疗效、复发率比较差异均未见统计学意义（P均〉0.05）。两组无进展生存期（PFS）及总生存期（OS）比较差异均未见统计学意义（P均〉0.05）。IDS组术中出血量、手术时间、住院时间、肠切除及上腹部手术患者比例均少于PDS组，且术后残留瘤体体积小于PDS组（P〈0.05）；两组需输血患者、输血量及排气时间等比较差异均未见统计学意义（P均〉0.05）。IDS组术后并发症发生率为21.2%，PDS组为28.3%，两组比较差异未见统计学意义（P〉0.05）。影响晚期卵巢癌患者OS的因素包括年龄、FIGO分期、原发最大肿瘤直径及术后残留病灶大小（P均〈0.05），且年龄、FIGO分期及术后残留病灶大小是影响晚期卵巢癌患者OS的独立因素。结论新辅助化疗无法显著提高肿瘤细胞减灭术满意度并改善患者预后，但其能够减少术中出血量、手术时间及住院时间，减小手术范围，缩少体积较大残留病灶，为患者创造手术机会。
ObjectiveTo investigate the effects of neoadjuvant chemotherapy on advanced epithelial ovarian cancer and the influencing factors of prognosis.MethodsClinical data of 126 patients with advanced epithelial ovarian cancer were retrospectively analyzed. The enrolled patients were divided into neoadjuvant chemotherapy ＋ intermittent cytoreductive surgery （IDS） group （66 cases） and initial cytoreductive surgery plus postoperative chemotherapy （PDS） group （60 cases）, according to the treatment methods. The baseline data characteristics, curative effect, prognosis, operation condition and postoperative complications of the two groups were compared, and the prognostic factors of advanced epithelial ovarian cancer were analyzed.ResultsThe total effective rate of IDS group and PDS group was 68.2% and 76.7%, respectively, and the recurrence rates were 62.2% and 63.0%, respectively, there was no significant difference in the effective rate and recurrence rate between the two groups （all P〉0.05）. There was no significant difference in progress free survival （PFS） and overall survival （OS） between the two groups （P〉0.05）. The intraoperative bleeding, operation time, hospital stay, intestinal resection and number of upper abdominal surgery patients in IDS group were significantly less than those in PDS group, the postoperative total residual tumor volume in IDS group was smaller than that in PDS group （P〈0.05）; there was no significant difference in requirement of blood transfusion, blood transfusion volume, exhaust time between the two groups （all P〉0.05）. The incidence of postoperative complications in IDS group was 21.2%, while the incidence of postoperative complications in PDS group was 28.3%, there was no significant difference between the two groups （P〉0.05）. Age, FIGO stage, the largest tumor diameter, and the size of residual lesions after operation were influencing factors of OS in patients with advanced ovarian cancer （all P〈0.05）. Age, FIGO staging and postoperative residual lesion size were independent factors of OS in patients with advanced ovarian cancer.ConclusionsNeoadjuvant chemotherapy can not significantly improve the satisfaction of cytoreductive surgery and the prognosis of the patients, but the application of neoadjuvant chemotherapy is conductive to reduce the intraoperative bleeding, operation time, hospital stay, scope of operation, and decrease residual disease with larger volume, so as to create opportunities for surgery.
作者
陈会晓
张凤丽
刘雪崴
杜静
王斌
庄献鹏
Chen Huixiao;Zhang Fengli;Liu Xuewei;Du Jing;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 Hospi- tal, Liaocheng 252000, Chin)
出处
《中国实用医刊》
2018年第11期71-74,共4页
Chinese Journal of Practical Medicine
关键词
卵巢癌
晚期
新辅助化疗
疗效
影响因素
Ovarian cancer
Advanced
Neoadjuvant chemotherapy
Efficacy
hffluencing factors
