不同给药途径的新辅助化疗在晚期上皮性卵巢癌的疗效观察

Curative Effects of Neoadjuvant Chemotherapy in Advanced Epithelial Ovarian Cancer Using Different Methods

目的:探讨新辅助化疗中不同给药方式在晚期上皮性卵巢癌的临床疗效及意义。方法:选取132例初治上皮性卵巢癌患者,临床分期为Ⅲc一Ⅳ期。随机平均分为4组(A组:单纯紫杉醇静脉化疗B组:单纯卡铂腹腔灌注C组:紫杉醇静脉联合卡铂腹腔D组:直接手术)。A、B、C三组给予1个疗程新辅助化疗后评估其疗效,行卵巢癌肿瘤细胞减灭术;D组直接手术治疗,比较各组治疗情况。结果:4组的满意肿瘤减灭率分别为78.8%、75.7%、87.9%、63.6%;化疗A、B与C组间、化疗各组与D组间在减灭术成功率、手术时间、术中出血量、术后排气时间上比较均有统计学意义(P<0.05);新辅助化疗各组不良反应可耐受,均顺利完成手术,其中骨髓抑制及神经毒性以C组发生率较高(P<0.01)。结论:1新辅助化疗可降低手术风险,有效提高满意的减灭术的成功率,改善生存质量。2静脉联合腹腔灌注较单途径用药的临床疗效好,毒副作用略高但可耐受。

Objective： To discuss the efficacy and the significance of neoadjuvant chemotherapy in advanced epithelial ovarian cancer using different methods of administration. Methods： 132 cases of initially treated epithelial ovarian cancer patients staged at IIIc to IV were selected and randomly divided into four groups： Group A received paclitaxel intravenous chemotherapy alone, while Group B were given carboplatin intra-peritoneal perfusion only, Group C received paclitaxel vein combined with carboplation intra-peritoneal, and Group D had operations. Groups A, B and C received one course of neoadjuvant chemotherapy, after which the efficacy was evaluated and then ovary tumor rebulking operations were performed, while Group D had operation without chemotherapy. The treatment efficacies were compared among the four groups. Results： The satisfactory tumor remove rates were, respectively, 78.8%, 72.7%, 87.9% and63.6% in the four groups. There were significance differences in tumor remove rates, operation time, intra-operative blood loss, and post-operation evacuation time among the neoadjuvant chemotherapy groups（Groups a, b and C）, as well as that between the chemotherapy groups and Group D（P〈0.05）. Adverse reactions in neoadjuvant chemotherapy groups were tolerable, operations were all performed successfully, while myelosuppression and neurotoxicity were higher in Group C（P〈0.01）. Conclusions：（1） The neoadjuvant chemotherapy can decrease the risk of operation, effectively improve the satisfactory tumor remove rate, as well as patients＇ life quality.（2） Intravenous combined intraperitoneal perfusion has better clinical efficacy than drug use in one single method, with slightly higher yet tolerable side effects. venous combining intraperitoneal perfusion is good way to clinical curative effect than channel alone, side effects slightly higher but can tolerate.