复发性卵巢上皮癌的治疗——附30例临床分析

Treatment of recurrent epithelial ovarian cancer (Clinical analysis of 30 cases)

本文对我院１９８９～１９９３年收治３０例复发性卵巢上皮癌，其中１６例术前、术后腹腔化疗加静脉化疗，１４例术后加静脉化疗，２年生存率分别为４３８％（７／１６）、１４３％（２／１４）（Ｐ＜００５）。结果表明以手术为主的综合治疗复发性卵巢上皮癌能提高生存率，腹腔化疗在辅助治疗中起重要作用。７６７％。术后残余瘤的大小仍是影响预后因素之一，本组术后残瘤≤２ｃｍ平均生存２０个月，与Ｍｏｒｉｓ［３］报道残余瘤≤２ｃｍ平均生存１６３～１８个月相似，因此认为二次手术虽然难度大，但应尽量切除复发灶及受侵的脏器，使残瘤直径最大限度≤２ｃｍ，提高最佳切除率，以利于增加二线化疗效果。３２化疗在辅助治疗中的作用卵巢癌复发的部位多数在盆腹腔内，这样给腹腔化疗带来有利的治疗条件。已证实腹腔化疗可使局部获得药物浓度高于静脉给药的１０～１０００倍［４］。Ｐｉｖｅｒ［５］报道腹腔化疗对难治性，复发性卵巢癌作为拯救性治疗方法。本组结果表明，１６例术前、术后腹腔化疗，其中有１１例腹水完全控制，１例肝转移缩小，４例陶氏腔结节结缩小，２年生存率为４３８％（７／１６）比术后单纯静脉化疗生存率１４３％（２／１４）要高。认为以手术为主的综合治?

From 1989～1993,30 patients with recurrent epithelial ovarian cancer were treated at our hospital.16 of 30 patients were adminstered by combing intraperitoneal chemotherapy of the pre-postoperation and intravenous infuison,14 patients were treated by postoperation and intravenous infusion.The 2-year survival rate was 43 8%(7/16)、14 3%(2/14)respectively ( P <0 05).Results suggest that surgery based combination therapy may improve the survival rate of recurrent epithelial ovarian cancer.The intraperitoneal chemotherapy play an importance role in the adjuvant therapy.