紫杉醇联合顺铂静脉腹腔化疗治疗晚期卵巢癌的疗效分析

Analysis on the therapeutic effects of intraperitoneal and intravenous chemotherapy with paclitaxel plus cisplatin on advanced ovarian carcinoma

目的比较顺铂腹腔或静脉途径用药联合紫杉醇静脉滴注治疗晚期卵巢癌的临床疗效和不良反应。方法选取2008年1月至2012年12月间收治的60例晚期卵巢癌确诊患者,用随机数字表法分为观察组和对照组,每组各30例。观察组患者采用紫杉醇静脉联合顺铂腹腔给药,对照组两种药物均静脉滴注,比较两组患者的临床疗效和不良反应。结果观察组患者总有效率、肿瘤反应和糖类抗原125有效率分别为96.7%、83.3%和93.3%,明显高于对照组的70.0%、56.7%和70.0%,组间差异均有统计学意义(P<0.05)。两组患者主要不良反应均为骨髓抑制、消化系统反应和脱发等。骨髓抑制主要表现为白细胞减少,以I～II度为主,观察组患者发生率为80.0%(24/30),低于对照组的83.3%(25/30),组间差异无统计学意义(P>0.05)。消化系统主要不良反应为恶心呕吐、腹痛腹泻,观察组患者发生率分别为40.0%(12/30)和53.3%(16/30),均低于对照组的50.0%(15/30)和56.7%(17/30),差异无统计学意义(P>0.05)。其他不良反应组间比较,差异无统计学意义(P>0.05)。结论紫杉醇静脉联合顺铂腹腔给药治疗晚期卵巢癌疗效更好,不良反应可以耐受,顺铂腹腔联合紫杉醇化疗是治疗晚期卵巢癌有效可行的治疗方法。

Objective To explore the therapeutic effects of intraperitoneal and intravenous chemotherapy of paclitaxel plus cisplatin on advanced ovarian carcinoma as well as its adverse reactions.Methods Randomized controlled design was applied,60 cases of advanced ovarian carcinoma admitted to our hospital from Jan 2008 to Dec 2012 were selected and randomly divided into observation group and control group. Patients in the observation group were treated with intraperitoneal and intravenous chemotherapy of paclitaxel plus cisplatin,while patients in the control group were treated with intravenous chemotherapy with them.the therapeutic effects and adverse reactions were observed and evaluated.Results The generally effective rate,the efficiency rate of tumor volume and CA125 in observation group were 96.7%,83.3% and 93.3%,which were obviously high than those in control groups,the difference was statistically significant（P 0.05）.the main adverse reactions were bone marrow depression,gastrointestinal reaction and hair loss etc.the main reaction in bone marrow depression was leukopenia,mainly occupied by I-Ⅱ,the occurrence rate in observation group was 82.6%,lower than that in control group.The main gastrointestinal reactions were vomiting,abdominal pain and diarrhea.the rates of which were 44.4% and 55.6%,lower than those in control group,the differences weren＇t statistically significant.The other reactions in two groups weren＇t been found significantly difference.Conclusions The intraperitoneal and intravenous chemotherapy with paclitaxel plus cisplatin had an obvious therapeutic effect on advanced ovarian cancer,and the adverse reactions were endurable,so it could be used as an alternative chemotherapy regimen for advanced ovarian cancer.