术前辅助化疗联合术后腹腔热灌注治疗老年卵巢癌的临床观察

Clinical Observation of Preoperative Adjuvant Chemotherapy Combined with Postoperative Hyperthermic Peritoneal Perfusion in the Treatment of Ovarian Cancer in the Elderly

目的探讨术前辅助化疗联合术后腹腔热灌注治疗的方案对老年卵巢癌患者的临床疗效,为治疗老年卵巢癌提供方法。方法选取老年卵巢癌患者82例,根据治疗方案的不同分为观察组(n=42)和对照组(n=40)。其中观察组给予术前新型辅助化疗+肿瘤减灭术+术后腹腔热灌注的治疗方案;对照组给予肿瘤减灭术+术后化疗的常规治疗方案。比较2组患者的手术一般情况,血液学相关指标,近、远期疗效,以及不良反应发生等情况。结果观察组患者手术时间、术中出血量、腹水量均小于对照组(P<0.01);2组患者住院时间的差异无统计学意义(P>0.05)。治疗后2组患者肿瘤相关标志物水平均降低,而观察组患者CA125和HE4水平均低于对照组(P<0.01)。观察组患者的近期疗效、远期疗效和平均生存期显著优于对照组(P<0.05)。2组患者毒副反应无显著差异(P>0.05)。结论辅助化疗联合术后腹腔热灌注治疗的方案对老年卵巢癌患者的临床疗效显著,具有一定的临床应用价值。

Objective To observe the clinical curative effect of preoperative adjuvant chemotherapy combined with postoperative hyperthermic peritoneal perfusion on ovarian cancer in the elderly.Methods 82 elderly with ovarian cancer were enrolled and were divided,according to the different treatment options,into 2 groups: observation group (n=42) and control group (n=40);preoperative new adjuvant chemotherapy+tumor reduction+postoperative abdominal perfusion was applied to cases in observation group while tumor reduction + postoperative chemotherapy to cases in control group;a comparative study was made to the general conditions of surgery,hematology-related indicators,short-term and long-term effects and adverse reactions between the 2 groups.Results The operation duration,intraoperative blood loss and ascites volume of the cases in observation group were shorter and smaller than those in control group (P<0.01);there was no significant difference in hospitalization time between the 2 groups (P>0.05);After treatment,the levels of tumor-associated markers decreased in the 2 groups,and the levels of VEGF and HE4 in observation group were lower than those in control group,the difference was of statistically significance (P<0.01);the short-termefficacy,long-termefficacy and the average survival time of the cases in observation group were much more superior to those of the cases in control group (P<0.05);no adverse reactions of significant differences were found between the 2 groups (P>0.05).Conclusion The adjuvant chemotherapy combined with postoperative peritoneal hyperthermic therapy is of significant clinical effect on ovarian cancer in the elderly and it is worthy of wider clinical application.