动脉介入化疗栓塞在晚期上皮性卵巢癌中的应用

Application of arterial interventional chemotherapy and embolization in advanced-stage epithelial ovarian cancer

目的：探讨动脉介入化疗栓塞在晚期上皮性卵巢癌治疗中的意义。方法：1999年12月1日至2012年5月31日在我院实施肿瘤细胞减灭术的晚期上皮性卵巢癌患者共100例，按术前是否行动脉介入化疗栓塞分为2组，即动脉介入化疗栓塞组（治疗组）和初次肿瘤细胞减灭术组（对照组）。治疗组27例，对照组73例，治疗组术前予1～2疗程动脉介入化疗栓塞后再行肿瘤细胞减灭术，对照组行初次肿瘤细胞减灭术，对其进行回顾性分析，比较2组患者临床各项指标、相关预后因素及累积生存率。结果：治疗组分级高、期别晚者所占比例高，但达到满意的肿瘤细胞减灭术者所占比例比对照组高，两者比较差异无统计学意义（P＞0.05）。多因素生存分析显示手术病理分期及手术满意度是影响患者总的生存率的独立预后因素（P=0.010及P=0.011）。治疗组3年和5年累积生存率分别为64%和48%，对照组为62%和40%，差异无统计学意义（P＞0.05）。结论：术前估计难以达到满意的肿瘤细胞减灭术的晚期上皮性卵巢癌患者，行动脉介入化疗栓塞可能提高手术的成功率，但不能提高患者总的生存率。

Objective： To explore the signicance of the arterial interventional chemotherapy and emboliza-tion in the treatment of advanced-stage epithelial ovarian cancer.Methods： From December 1, 1999 to May 31, 2012, 100 patients of epithelial ovarian cancer in advanced-stage were admitted and all of them had cytoreduc-tive surgery in our hospital. According to whether or not to accept the arterial interventional chemotherapy and embolization, patients of advanced-stage epithelial ovarian cancer were divided into two groups before cytore-ductive surgery. Those were the arterial interventional chemotherapy and embolization group （the treated group） and primary cytoreductive surgery group （the control group）. There were 27 cases in the treated group which had 1-2 courses of the arterial interventional chemotherapy and embolization before operation. While the other 73 cases in the control group had initial cytoreductive surgery. The results were analyzed retrospectively, compar-ing the two groups of patients with clinical indicators, related prognostic factors and the cumulative survival rate. Results： Comparison of factors between the two groups showed that the treatment group with high grade, stage late accounts for the proportion to be high. However, the rates of optimal cytoreductive surgery in the treated group were higher than that of the control group. There was no statistically signiifcant difference between the two groups （P〉0.05）. Multivariate survival analysis showed that pathological staging and operation satisfaction were independent prognostic factors affecting overall survival rates for patients （P=0.010 andP=0.011）. The 3-year and 5-year cumulative survival rates were 64% and 48% in the treated group, while 62% and 40% in the control group. There was no statistically signiifcant difference between the two groups （P〉0.05）.Coclusions： Patients of advanced-stage epithelial ovarian cancer who can not to achieve optimal cytoreductive surgery should receive preoperative arterial interventional chemotherapy and embolization. It may improve the success rate of the opera-tion, but can not improve the overall cumulative survival rate.