术前IFN联合DDP、VP-16腹腔化疗治疗晚期卵巢癌合并腹水37例临床体会

IFN combination DDP、VP-16 preoperative intraperitoneal chemotherapy for the treatment of advanced epithelial ovarian cancer with ascites

目的对晚期卵巢上皮性癌合并腹水的患者给予术前干扰素(IFN)联合顺铂(DDP)、足叶乙甙(VP-16)腹腔化疗,探讨IFN提高化疗疗效的作用。方法本研究纳入37例晚期卵巢上皮性癌患者(FIGO分期Ⅲc期),术前给予DDP+VP-16腹腔化疗2个疗程,加用IFN(A组)21例,未用IFN(B组)16例。比较2组行肿瘤细胞减灭术后的疗效。结果术后通过手术标本的镜检分析证实,A组与B组相比标本中癌细胞较多发生中、重度化疗反应,有些瘤组织大片坏死,细胞界限不清,甚至有抑制核分裂的表现,从而使肿瘤细胞活性大大降低,但2组比较差异无显著性(P>0.05)。A组的全部缓解率(CR)为72%,与B组(56%)相比较,差异无显著性(P>0.05);但从总有效率(CR+PR)来看,A组(89%)较B组(62%)有显著性差异(P<0.05)。A、B两组化疗毒副作用比较差异无显著性(P>0.05)。结论应用IFN联合DDP、VP-16术前腹腔化疗方案,能够更有效地杀灭癌细胞,控制腹水和缩小病灶,提高手术质量和治疗效果。

Objective The purpose of this study was to evaluate differences in the tumor remission rate in women with advanced epithelial ovarian carcinoma（EOC） treated with DDP＋VP-16 preoperative intraperitoneal chemotherapy combination with or without IFN.Methods In a randomized,retrospective study,all patients with advanced EOC of FIGO stage Ⅲc and ascites were treated between 2002 and 2009 at our hospital,and received 2 cycles of DDP＋VP-16 preoperative intraperitoneal chemotherapy.21 patients received combination chemotherapy with IFN（A groug）and 16 patients received combination chemotherapy without IFN（B group） followed by tumor debulking surgery.The two groups were investigated and compared with respect to tumor remission rate.Results Optimal cytoreduction was achieved more often in patients who received combination chemotherapy with IFN.The complete rate（CR） of A group（72%） was not significantly than A group（56%）.However,the total remission rate（CR＋PR） for patients managed with IFN（A group,89%） was statistically significantly superior compared to patients treated without IFN（A group,62%）（P 〉0.05）.Conclusions Higher tumor remission rate and safe can be achieved in these patients with advanced EOC of FIGO stage Ⅲc with ascites by the use of DDP＋VP-16 preoperative intraperitoneal chemotherapy.Patients will benefit from combination with IFN.