卵巢内胚窦瘤的联合化疗

Response of ovarian endodermal sinus tumor to combination chemotherapy with cis-platinum,vincristine and bleomycin or vincristine,actinomycin and cyclophosphamide

分析我院１９７７年８月至１９９２年４月收治的６３例卵巢内胚窦瘤患者手术后联合化疗的效果。根据所采用的不同联合化疗方案，将患者分为３组，第１组：采用长春新碱、更生霉素及环磷酰胺（ＶＡＣ）或顺铂、长春新碱及平阳霉素（ＰＶＢ）足量治疗，３７例；第２组：ＶＡＣ或ＰＶＢ不足量治疗，１７例；第３组：其他联合化疗方案９例。６３例中２８例死亡。存活的３５例的随诊时间为１～１５年。第１、２、３组的持续缓解率分别为８１．８％，２３．５％及１１．１％。结果显示：卵巢内胚窦瘤对ＶＡＣ或ＰＶＢ联合化疗很敏感，化疗足量并及时，是治疗成功的关键。手术是否清扫淋巴结以及肿瘤细胞减灭术后残存肿瘤的大小，与存活率之间没有正相关的关系。初治病例的疗效明显优于复发病例，前者的持续缓解率为９４．７％，后者为６６．７％。

he treatment results of 63 cases of ovarian endodermal sinus tumor admitted to Peking UnionMedical College Hospital from August 1977 through April 1992 by combination chemotherapy were re-ported. Patients were divided into three groups. The first group received full courses of vincristine, acti-nomycin and cyclophosphamide(VAC)or cis-platinum,vincristine and bleomycin(PVB ) chemotherapyin adequate dosages (37 cases).The second group also received VAC or PVB chemotherapy but in inad-equate dosages(17 cases).The third group took no VAC or PVB chemotherapy but some otherchemotherapeutic drugs(9 cases). 28 of the 63 patlents died. The 35 surviving patients have been fol-lOwed for 1 to 15 years. The sustained remission rates were 81.1%, 23.5%and 11.1%for the first,second and third group respectively. As the ovarian endodermal sinus tumor is very sensitive to VAC orPVB chemotherapy an extensive or aggressive cytoreductive surgery and retroperitoneal lymphadenec-tomy seemed to be not necessary. Such a point of view is demonstrated by our preliminary study. Thetreatment results for the primary cases are significantly better than that of the recurrent cases. The sus-tained remission rate is 94.7% for the former while that for the latter is 66.7%.