TP方案新辅助化疗晚期卵巢癌38例疗效观察

Observation of TP Scheme Neoadjuvant Chemotherapy’s Curative Effect on 38 Patients with Advanced Ovarian Cancer

目的观察新辅助化疗对晚期卵巢癌的临床意义。方法 78例晚期卵巢癌患者随机分为新辅助化疗组(A组38例)及先期手术组(B组40例),新辅助化疗组采用TP方案(紫杉醇联合顺铂)化疗2～3周期后予肿瘤细胞减灭术,术后继续该方案化疗4～6周期;先期手术组施行肿瘤细胞减灭术后使用同一方案化疗6～8周期,评价新辅助化疗的临床疗效。结果新辅助化疗2～3周期后有效率71.05%,无患者出现疾病进展。手术基本切净率81.58%,与先期手术组比较有统计学差异(P<0.01);缩短了手术时间,减少了术中出血量,术后并发症减少(P<0.01);中位生存期33.6个月,1年生存率79.8%(30/38),3年生存率36.8%(14/38),均明显优于先期手术组(P<0.05)。结论 TP方案新辅助化疗2～3周期能降低晚期卵巢癌的分期,提高手术切净率,改善患者预后,可在临床推广使用。

Objective To observe the clinical significance of neoadjuvant chemotherapy for advanced ovarian cancer.Method 78 patients with advanced ovarian cancer,divided into the neoadjuvant chemotherapy group（group A 38cases）and the advanced operation group（group B40 cases）.The neoadjuvant chemotherapy group was given a TP scheme（paclitaxel in conjunction with cisplatin）,with 1to 3 cycles of chemotherapy,and then received cytoreductive surgery,post-op this group continued this program of chemotherapy for 4-6 cycles;the advanced operation group only used the same program of chemotherapy for 6-8 cycles after receiving cytoreductive surgery,in order to evaluate the clinical curative effect of neoadjuvant chemotherapy.Results The efficiency rate of neoadjuvant chemotherapy after 2 to 3 cycles was 71.05%,no patients experienced any disease progression.The initial incision length of the operation（for Group A）is reduced by 81.58%,compared to the advanced operation group（P0.01）,this is statistically significant.Neoadjuvant chemotherapy shortened the surgery time,decreased blood loss volume,and has fewer postoperative complications（P0.01）;the median survival rate is 33.6 months,1-year survival rate is 79.8%（30/38 patients）,a 3-year survival rate 36.8%（14/38 patients）,this is significantly better than the advanced operation group（P0.05）Conclusion TP scheme neoadjuvant chemotherapy for 2～3 cycles can reduce advanced ovarian cancer’s staging,enhance the operation precision rate,improve the prognosis for patients,can be used in the clinical practice.