NACT联合CDS及术后IPHC治疗晚期卵巢癌的疗效分析

Efficacy of NACT combined with CDS and IPHC in the Treatment of Patients with Advanced Ovarian Cancer

目的探讨新辅助化疗(NACT)+肿瘤细胞减灭术(CDS)+术后腹腔热灌注治疗(IPHC)+常规化疗方案对晚期卵巢癌的疗效。方法选择晚期卵巢癌患者240例,将其随机分为观察组(120例)与对照组(120例)。观察组患者给予NACT+CDS+术后IPHC治疗,对照组患者则采用CDS+顺铂化疗治疗。治疗前后,比较两组患者术中各手术指标、炎性因子水平、外周血T淋巴细胞亚群指标变化以及临床疗效。结果观察组患者手术时间、住院时间、术中失血量、术中腹腔积液量都显著优于对照组(P<0.05);治疗后,两组血清糖类抗原125(CA125)、癌胚抗原(CEA)以及中性粒细胞(N)/淋巴细胞(L)比值均显著下降,观察组小于对照组(P<0.05);治疗后,CD3+、CD4+和CD8+T淋巴细胞均显著下降,观察组大于对照组(P<0.05),观察组CD4+/CD8+T淋巴细胞比值显著升高,而对照组CD4+/CD8+T淋巴细胞比值下降(P>0.05),两组比较,观察组显著大于对照组(P<0.05);观察组患者总有效率为84.17%,显著高于对照组患者总有效率70.83%(P<0.05);观察组的复发率和死亡率都显著低于对照组。结论NACT联合CDS及术后IPHC治疗晚期卵巢癌有较好的临床疗效,能显著改善患者的手术指标,降低T淋巴细胞亚群指标水平,延长患者存活率。

Objective To investigate the efficacy of neoadjuvant chemotherapy(NACT)+tumor cell reduction(CDS)+postoperative intraperitoneal hyperthermic perfusion therapy(IPHC)+conventional chemotherapy in the treatment of patients with advanced ovarian cancer.Methods 240 patients with advanced ovarian cancer were selected,the patients were randomly divided into the observation group(120 cases)and the control group(120 cases).The patients in the observation group were treated with NACT+CDS+IPHC after operation,while the patients in the control group were treated with CDS+cisplatin chemotherapy.Before and after treatment,the changes of operative indexes,inflammatory factors,T lymphocyte subsets in peripheral blood and clinical efficacy were compared between the 2 groups.Results The operation time,hospitalization time,intraoperative blood loss and intraoperative peritoneal effusion in the observation group were significantly better than those in the control group(P<0.05).After treatment,the serum levels of carbohydrate antigen 125(CA125),carcinoembryonic antigen(CEA)and neutrophil(N)/lymphocyte(L)ratio of the two groups decreased significantly,and the observation group was smaller than the control group(P<0.05).After treatment,the levels of CD3+,CD4+and CD8+T lymphocyte decreased significantly,the observation group was larger than the control group(P<0.05),the observation group CD4+/CD8+T lymphocyte ratio increased significantly,while the control group CD4+/CD8+T lymphocyte ratio decreased(P>0.05),the observation group was significantly larger than the control group(P<0.05).The total effective rate in the observation group was 84.17%,which was significantly higher than that of 70.83%in the control group(P<0.05).The recurrence rate and mortality rate of the observation group were significantly lower than those of the control group.Conclusion NACT combined with CDS and IPHC has a good clinical effect in the treatment of patients with advanced ovarian cancer.It can significantly improve the surgical indicators of patients,reduce the level of T lymphocyte subsets and prolong the survival rate of patients.