先期化疗对晚期上皮性卵巢癌患者术前状态及手术疗效的影响

Influence of primary chemotherapy on preoperative state and efficacy of surgery in patients with advanced epithelial ovarian cancer

目的探讨先期化疗对晚期上皮性卵巢癌患者术前状态及手术疗效的影响。方法回顾性分析82例晚期上皮性卵巢癌患者的临床资料,按照治疗方式的不同将患者分为观察组和对照组,每组41例。观察组患者采取先期化疗后手术的治疗方案,对照组患者采取直接手术的治疗方案,比较两组患者的术前状态、术中及术后恢复情况。结果观察组患者的术前体力状况(ZPS)评分情况、腹腔积液控制情况均明显优于对照组患者(P﹤0.01)。观察组患者术前及术后的血清CA125水平均明显低于对照组患者,差异均有统计学意义(P﹤0.01)。观察组患者的总有效率为68.3%(28/41),高于对照组患者的46.3%(19/41),差异有统计学意义(P﹤0.05)。观察组患者的手术时间、术中出血量、术后通气时间及术后血象恢复时间均少于对照组患者,差异均有统计学意义(P﹤0.05)。两组患者术后并发症的发生率比较,差异无统计学意义(P﹥0.05)。结论先期化疗可有效改善晚期上皮性卵巢癌患者的术前状态,并有助于提高手术疗效,改善短期治疗效果,值得临床推广应用。

Objective To investigate the effect of primary chemotherapy on preoperative state and efficacy of surgery in patients with advanced epithelial ovarian cancer. Method A retrospective analysis including the clinical data of 82 patients with advanced epithelial ovarian cancer was performed. The patients were grouped by treatment modality as study group and control group, with 41 cases in each. The study group accepted primary chemotherapy before surgery, and the control group had surgery directly. The preoperative state, intraoperative condition and postoperative recovery of the two groups were compared. Result The ZPS score and control over peritoneal effusion of the study group were significantly better than that of the control group（P0.01）. The level of CA125 in study group before and after surgery were significantly lower than that in control group, the difference was statistically significant（P0.01）. The total response rate in study group was 68.3%（28/41）, which was higher than that of control group at 46.3%（19/41）, showing statistically significant difference（P0.05）. The operative time, intraoperative blood loss, anal exhaust time and the recovery time of hemogram after surgery were significantly shorter than those in the control group（P0.05）. There was no significant difference in the incidence of postoperative complications between the two groups（P0.05）. Conclusion Primary chemotherapy can effectively improve the preoperative status and the curative effect forpatients with advanced epithelial ovarian cancer,with better short-term efficacy, and it is clinically applicable.