上皮性卵巢癌满意减灭术后TP、CBP方案化疗的疗效比较

Comparison of Therapeutic Efficacy between TP Regimen and CBP Regimen on Epithelial Ovarian Cancer after Optimal Cytoreductive Operation

背景与目的:上皮性卵巢癌的治疗以手术加化疗的综合治疗最为有效。手术强调彻底性,化疗方案目前多认为TP(paclilaxel,carboplatin/cisplatin)为优选,但仍有争论。本研究回顾性对照分析满意减灭术后,应用TP和CBP(cyclophosphamide,bleomycin,carboplatin/cisplatin)方案作为一线化疗方案的两组患者的生存情况,旨在比较TP和CBP方案作为上皮性卵巢癌满意减灭术后一线化疗方案的疗效。方法:选取满意减灭术后应用TP方案为一线化疗方案的患者60例和以CBP方案为一线方案的患者65例,分别比较其3年生存率、3年无瘤生存率、3年内复发病例的无进展生存期、3年生存分析和无瘤生存分析,以及主要的不良反应。结果:CBP、TP两组3年生存率分别为69.2%、75.3%(P=0.473);3年无瘤生存率分别为38.5%、43.3%(P=0.580);3年内复发病例的中位无进展生存期分别为12个月、13个月(P=0.672);比较两组3年生存分析和无瘤生存分析曲线,P值分别为0.285和0.517。两组间比较差异均无显著性。各项不良反应除周围神经毒性外,两组之间的差异也无显著性。结论:对满意减灭术后上皮性卵巢癌患者用TP方案化疗的效果与传统CBP方案相当。

BACKGROUND ＆ OBJECTIVE： The most effective treatment for epithelial ovarian cancer is the combination of surgical operation and chemotherapy. Complete removal of the tumor is the key of surgical treatment; TP regimen （paclitaxel plus carboplatin） is the preference for postoperative chemotherapy, but its superiority is controversial. This study was to compare the efficacy of TP regimen and CBP regimen （cyclophosphamide, bleomycin plus carboplatin/cisplatin） on epithelial ovarian cancer. METHODS： Clinical data of 125 patients with stage Ⅱ b-Ⅳ epithelial ovarian cancer, underwent optimal cytoreductive operation and received regular postoperative chemotherapy in Cancer Center of Sun Yat-sen University, were analyzed. Of the 125 patients, 65 were treated with CBP regimen, 60 were treated with TP regimen. The 3-year survival statuses and main adverse events were compared between the 2 groups. RESULTS： The 3-year survival rates were 69.2% in CBP group and 75.3% in TP group （P= 0.473）; the 3-year tumor-free survival rates were 38.5% and 43.3% respectively （P=0.580）; the medians of progression-free survival time of the patients with recurrent disease were 12 months and 13 months, respectively （P=0.672）. The comparisons of overall survival curves and tumor-free survival curves between the 2 groups showed no significant differences, too （P= 0.285 and P=0.517）. The comparisons of adverse effects between the 2 groups showed no significant differences except for neurologic toxicity. CONCLUSION： TP regimen and CBP regimen have identical therapeutic effects when used as first-line chemotherapy regimen for epithelial ovarian cancer after optimal cytoreductive operation.