新辅助化疗治疗晚期卵巢癌的疗效观察

Observation on the clinical efficacy of neoadjuvant chemotherapy in treatment of patients with advanced ovarian cancer

目的:探讨新辅助化疗对晚期卵巢癌患者带瘤状态、手术效果及预后的影响,为临床合理设计晚期卵巢癌治疗方案提供参考。方法:回顾性分析同济医院2001年1月～2007年12月68例接受新辅助化疗的晚期卵巢癌患者与同期未行化疗而先行减瘤术的115例晚期卵巢癌患者在肿瘤缩小、手术难度、残余瘤灶、近期预后等方面的差异。结果:Ⅲc期和Ⅳ期卵巢癌新辅助化疗组的患者临床有效率分别为87.10%和83.78%;新辅助化疗组患者较未行化疗组患者的肿瘤大小、腹水量、手术难度、副损伤及残余瘤灶均明显减少;新辅助化疗组患者的1年生存率、3年生存率及中位生存时间均稍高于未行化疗组,但其差异均无统计学意义。结论:新辅助化疗可明显减小肿瘤体积,减少腹水及转移灶,有利于手术的安全性和彻底性,尽管在近期预后方面未见明显改善,但对晚期卵巢癌患者仍是一种重要的治疗策略。

Objective：To explore the effect of neoadjuvant chemotherapy on situation,surgical effect and short term prognosis of patients with advanced ovarian cancer,provide a basis for designing a reasonable therapeutic schedule for advanced ovarian cancer.Methods：The differences of the degree of tumor reduction,surgical difficulty,residual tumor foci and recent prognosis were analyzed retrospectively in the hospital from January 2001 to December 2007 between 68 patients with advanced ovarian cancer who received neoadjuvant chemotherapy and 115 patients with advanced ovarian cancer who received tumor cytoreduction.Results：In neoadjuvant chemotherapy group,the effective rates in the patients with advanced ovarian cancer of stage Ⅲc and Ⅳ were 87.10% and 83.78%,respectively;the size of tumor,the volume of ascites,surgical difficulty,side-injury and residual tumor foci in neoadjuvant chemotherapy group were significantly lower than those in non-neoadjuvant chemotherapy group;1-year survival rate,3-year survival rate and median survival time in neoadjuvant chemotherapy group were slightly higher than those in non-neoadjuvant chemotherapy group,but there was no significant difference.Conclusion：Neoadjuvant chemotherapy can reduce the size of tumor obviously,decrease ascites and metastatic foci,which contributes to the safety and thoroughness of operation;even though neoadjuvant chemotherapy doesn＇t improve short term prognosis significantly,it is still an important therapeutic schedule for patients with advanced ovarian cancer.