新辅助化疗后腹式中间型肿瘤细胞减灭术治疗卵巢上皮癌ⅢC期的临床研究

Clinical study of abdominl type of tumor cells to destroy the loss after neoadjuvant chemotherapy in treatment of epithelial ovarian cancer stage Ⅲ C

目的观察新辅助化疗后腹式中间型肿瘤细胞减灭术治疗ⅢC期卵巢上皮癌的效果。方法选择我院2010年6月至2012年6月收治的80例ⅢC期卵巢上皮癌患者作为研究对象，均符合诊断标准及无明显手术禁忌证，采用随机数字表法将入组对象分为观察组和对照组，每组40例，观察组先给予新辅助化疗后再行腹式中间型肿瘤细胞减灭术治疗，对照组给予腹式中间型肿瘤细胞减灭术治疗，术后两组均行紫杉醇＋卡铂化疗，比较两组疗效。结果观察组术中失血量（512.6±98.6） ml低于对照组（785.6±91.2） ml，差异有统计学意义（P〈0.01）；观察组手术时间（215.6±42.6） min低于对照组（285.6±43.9） min，差异有统计学意义（P〈0.01）；观察组患者腹水量（689.5±215.6） ml少于对照组（1 265.9±325.6） ml，差异有统计学意义（P〈0.01）。两组术后住院时间比较差异无统计学意义（P〉0.05）。近期疗效中观察组治疗后完全缓解11例（ 27.5%），部分缓解24例（60.0%），稳定4例（10%，4/40），进展1例（2.5%，1/40）；对照组完全缓解5例（ 12.5%），部分缓解9例（22.5%），稳定20例（50%，20/40），进展6例（15.0%，6/40），两组比较差异有统计学意义（P〈0.01）。观察组3年生存率92.5%显著高于对照组72.5%（P＝0.039）。结论新辅助化疗后腹式下中间型肿瘤细胞减灭术治疗ⅢC期卵巢上皮癌疗效较佳，具有重要临床价值。

Objective To investigate the effect of abdominl type of tumor cells to destroy the loss after neoadjuvant chemotherapy in treatment of epithelial ovarian cancer stage ⅢC.Methods Eighty cases patients of stage ⅢC epithelial ovarian cancer who were treated in Traditional Chinese Medicine Hospital of Meizhou from June 2010 to June 2012 were enrolled in this study and all were consistent with the diagnostic criteria and no operation contraindications.They were randomly divided into two groups with 40 cases in each group according to the paired grouping method.The observation group was treated with abdominal type intermediate tumor cell reduction surgery after neoadjuvant chemotherapy, and the control group was treated with abdominal intermediate tumor cells.Two groups were treated by paclitaxel and carboplatin chemotherapy after the operation, the curative effect between the two groups was compared.Results Blood loss during operation of patients in observation group were lower than control group, the difference was significant（（512.6±98.6） ml vs.（785.6±91.2） ml, P〈0.001）. The operation time of patients in observation group was shorter than that of control group, the difference was significant（（215.6±42.6） min vs.（285.6±43.9） min, P〈0.01）. The ascites of patients in observation group were less than that of control group, the difference was significant（（689.5±215.6） ml vs.（1 265.9±325.6） ml, P〈0.01）. There was no significant difference in the length of stay between the two groups（P〉0.05）. There were 11 cases（27.5%） of complete remission, 24 cases（60.0%） of partial remission, 4 cases of stable （10%, 4/40）, 1 case （2.5%, 1/40） of progress in the observation group recently; while in control group, complete remission in 5 cases（12.5%）, partial remission in 9 cases（22.5%）, stable in 20 cases（50%, 20/40）, progress in 6 cases（15.0%, 6/40）, the differences between the two groups were statistical significance（P〈0.001）. The 3 year survival rate of observation group was significantly higher than that of control group（92.5% vs.72.5%, P=0.0394）.Conclusion The effect of abdominl type of tumor cells to destroy the loss after neoadjuvant chemotherapy in treatment of epithelial ovarian cancer stage IIIC is better, it has the important clinical value.