双路径先期化疗对Ⅲ期卵巢癌疗效和预后的影响

Influence of double-way pre-chemotherapy on therapeutic efficacy and prognosis of stage-Ⅲ ovarian cancer

目的探讨双路径先期化疗对Ⅲ期卵巢癌肿瘤细胞减灭术加术后化疗疗效和预后的影响。方法将36例Ⅲ期卵巢癌分为A、B两组,A组行双路径先期化疗加中间肿瘤细胞减灭术加术后化疗(22例);B组行初次肿瘤细胞减灭术加术后化疗(14例)。比较两组肿瘤细胞减灭术的彻底性、病情缓解率和生存率。结果A、B组达到理想肿瘤细胞减灭术者分别占86.4%和35.7%;手术时间分别为(190±20)m in和(270±30)m in;术中出血分别为(400±100)m l和(800±200)m l;病情缓解率分别为77.3%和35.7%;1,3年生存率分别为90.9%、64.3%和68.2%、35.7%(P<0.05),5年生存率分别为31.8%和21.4%(P>0.05)。结论双路径先期化疗用于Ⅲ期卵巢癌治疗,可以降低肿瘤细胞减灭术风险,提高理想肿瘤细胞减灭术比例和术后化疗反应率,对生存率有益。

Objective To explore the influence double-way of pre-chemotherapy on therapeutic efficacy stage-Ⅲ ovarian cancer. Methods Thirty-six case of stage-Ⅲ ovarian cancer were divided into two groups： A and B. Twenty-two cases in group A received double-way prechemotherapy plus middle-stage tumor cell reduction-extinction treatment and postoperative chemotherapy ; 14 cases in group B received primary tumor cell reduction-extinction treatment plus postoperative chemotherapy. The thoroughness of tumors cell reduction-extinction, disease alleviation rate and survival rate between the two groups were compared. Resuits The rates of ideal reduction-extinction of tumor cells were 86.4% and 35.7% in group A and group B respectively. The operation time was 190 ± 20 min and 270 ± 30 min respectively. The bleeding during operation was 400 ± 100ml and 800 ± 200 ml respectively. The disease alleviation rates ware 77.3% and 35.7% respectively. The 1-year and 3-years survival rates were 90.9% ,64.3% and 68.2% ,35.7% respectively（ P 〈0.05 ）. All these had remarkable difference between the 2 groups. The 5-year survival rates were 31.8 % and 21.4 % respectively （ P 〉 0.05 ）, with no remarkable difference. Conclusions Double-way pre-chemotherapy for treatment of stage-Ⅲ ovarian cancer can reduce the risk of tumor cell reduction-extinction technique, and can enhance the ideal tumor cell reduction-extinction rate and the response rate of chemotherapy. It is beneficial to the survival rate.