老年卵巢癌患者对手术和术后辅助化疗耐受性的分析

The tolerance of elderly ovarian cancer patients to surgery and adjuvant chemotherapy

目的观察老年卵巢癌患者对手术和术后辅助化疗的耐受性。方法回顾性分析我院2003--2006年136例接受手术、术后卡铂联合紫杉醇-线辅助化疗的卵巢癌患者的临床资料，32例≥65岁为老年组，104例〈65岁为对照组，比较两组手术前后及辅助化疗的情况。结果两组的肿瘤病理类型、分化程度和临床手术病理分期，差异无统计学意义。手术前老年组血红蛋白低于对照组[分别为（112土7）g／L和（126±13）g／L，P〈0．053，血清白蛋白和血清肿瘤抗原125（CAl25）水平，差异无统计学意义。老年组并存糖尿病（25．0％）高于对照组（9．6％），并存其他疾病两组差异无统计学意义。两组术中失血、输血差异无统计学意义。对照组满意减灭率（55．0％）高于老年组（44．0％），但差异无统计学意义；老年组淋巴结清扫率（79．0％）显著低于对照组（95．0％）；手术中泌尿系统、肠管损伤，两组比较差异无统计学意义；手术后早期cAl25老年组高于对照组，分别为（64±21）μg／L和（23±19）μg／L。手术后，两组在化疗疗程数、化疗持续时间、每疗程紫杉醇剂量、每疗程卡铂剂量比较，差异均无统计学意义。术后一线辅助化疗的重度不良反应差异无统计学意义。两组化疗期间血白蛋白、体力状况评分（PS）评分、化疗完成后CAl25水平，差异无统计学意义。结论老年卵巢癌患者对手术和术后辅助化疗的耐受性较好，与非老年卵巢癌患者无差异。

Objective To observe the tolerance of elderly ovarian cancer patients to surgery and adjuvant chemotherapy. Methods One hundred and thirty-six cases with ovarian cancer treated by surgery and adjuvant chemotherapy were reviewed. Among these patients, 32 cases were 65 years old or more （study group） and 104 cases were less than 65 years old（control group）. The status of pre -operation, during-operation and adjuvant chemotherapy were compared between the 2 groups. Results The pathological type, pathological grade and clinical-pathological staging were all similar between the 2 groups. Before surgery, the hemoglobin （Hb） level of study group（（112±7）g/L] was less than the control group（（126± 13）g/L]. There was no significant difference in serum a lbumine and CA125 levels before surgery. The study group had more diabetes mellitus（25.0%） than control group（9.6 %） and there were no significant differences on other medical history. During surgery, the blood lost and blood infusion rate were similar between the 2 groups. The optimal cytoreduction rates were 55.0% in control group and 44.0% in study group, respectively （P〉0. 05）. The lymphoectomy rate of study group（79.0%） was significantly less than the control group （95.0%）. The occurrence rates of operation complications, such as urinary and bowel hurt, were very low in both 2 groups without significant difference. The serum CA125 level within 2 weeks after operation was significantly higher in study group [（64 ± 21 ） μg/L] than in the control group [（23±19） μg/L]. The adjuvant chemotherapy after surgery, the total cycles, total treatment time, paclitaxol dose per cycle, carboplatin dose per cycle, 3/4 grade toxicity of chemotherapy, serum albumine level during chemotherapy, PS score during treatment, serum CA 125 level after chemotherapy were all similar between the 2 groups. Conclusions The tolerance to surgery and adjuvant chemotherapy is similar between elderly women and non-elderly women.