卵巢上皮癌TCI化疗方案的疗效研究及远期预后探讨

Therapeutic efficacy of TCI chemotherapy regimen for epithelial ovarian cancer and its long-term prognosis

目的探讨TCI联合化疗方案对于卵巢上皮癌的疗效及远期预后。方法 2000年2月~2010年12月在本院进行规范治疗的卵巢上皮癌158例,运用TCI治疗方案为88例,其化疗方案为TP和/或CAP和/或IAP（简称TCI方案）;对照组治疗70例,方案选择为PC（环磷酰胺与顺铂）,比较两组的临床缓解情况、毒性反应及远期预后,并且对TCI组进行COX系统回归因素分析。结果 TCI治疗组总体缓解率明显高于对照组,毒性反应方面TCI治疗组的血液系统及神经系统不良反应均显著低于PC组,胃肠道不良反应与心血管系统反应则无显著差异;TCI组5年平均生存率为31.2%,病理分期Ⅰ、Ⅱ、Ⅲ、Ⅳ期中位生存时间分别是79、56、22、18个月,残留灶小于2 cm者和治疗次数大于6次者远期预后明显好与相对应者。结论 TCI化疗方案显著优于PC方案,且不良反应相对较少,但胃肠道反应应引起重视,在预后各种因素方面病理分期、术后残留及疗程多少均具有一定相关意义。

Objective To explore the therapeutic efficacy of TCI combined chemotherapy regimen for and its long-term prognosis of epithelial ovarian cancer.Methods A total of 159 patients with epithelial ovarian cancer who received treatments from February 2000 to December 2010 in our hospital were included in the study.Among them,88 patients were administered with TP and/or CAP and/or IAP regimen（TCI regimen）.The control group included 70 patients who were administered with PC（cyclophosphamide and cisplatin）.The clinical remission,toxic reactions and long-term prognosis were compared between the two groups.Cox system was applied to the TCI group for regression factor analysis.Results The overall remission was significantly higher in the TCI group than in the control group.In terms of toxic reactions,the adverse reactions of hematological system and nerve system in the TCI group were significantly lower than those in the PC group.The two groups showed no significant differences in adverse gastrointestinal reactions and cardiovascular reactions.The average 5-year survival rate was 31.2% in the TCI group.Pathological stages were classified into stages Ⅰ,Ⅱ,Ⅲ and Ⅳ.The median survival time was 79,56,22 and 18 months,respectively.The long-term prognosis was obviously better in the patients whose residual tumor was less than 2 cm and the number of treatment more than 6 times than in the counterparts.Conclusions TCI chemotherapy regimen is better than the PC one with relatively less adverse reactions,but the gastrointestinal reactions should be taken into account seriously.In factors influencing prognosis,pathologic stages,postoperative residue and treatment duration are of certain significance.