卡铂联合紫杉醇腹腔化疗对高级别浆液性卵巢癌的疗效

The clinical effect of intraperitoneal chemotherapy utilizing carboplatin and paclitaxel on high-grade serous ovarian cancer

目的:研究卡铂联合紫杉醇腹腔化疗对高级别浆液性卵巢癌(HGSOC)的疗效。方法:选取2015年1月至2019年7月温州医科大学附属第一医院收治的110例HGSOC患者,根据治疗方式不同分为卡铂联合紫杉醇静脉化疗组(A组)34例,卡铂联合紫杉醇腹腔化疗组(B组)30例,顺铂联合紫杉醇腹腔化疗组(C组)28例,传统化疗药(环磷酰胺、阿霉素等)静脉化疗组(D组)18例。比较各组患者生存情况及不良反应,评判卡铂联合紫杉醇腹腔化疗治疗HGSOC的实用性、有效性与安全性。结果:A组、B组、C组5年生存率较D组均显著增高,组间差异有统计学意义(P<0.05);B组、C组3年生存率亦较D组增高,组间差异有统计学意义(P<0.05);而A组、B组、C组间3年、5年生存率差异均无统计学意义(P>0.05)。4组间Ⅲ、Ⅳ级骨髓抑制的发生率差异均无统计学意义(P>0.05)。Ⅲ、Ⅳ级胃肠道反应与腹痛发生情况:C组、D组分别与A组、B组比较,差异均有统计学意义(P<0.05),但A组与B组间、C组与D组间差异无统计学意义(P>0.05)。4组间皮疹发病率差异无统计学意义(P>0.05)。结论:卡铂联合紫杉醇腹腔化疗可以延长HGSOC患者的生存时间,提升临床治疗效果,且不良反应较小。

Objective:To investigate the curative effect of carboplatin/paclitaxel intraperitoneal chemotherapy on high-grade serous ovarian cancer(HGSOC).Methods:According to the diagnostic result given by senior pathologists from our hospital,110 cases of the most typical high-grade serous ovarian cancer were selected from numerous gynecological tumor slices of the First Affiliated Hospital of Wenzhou Medical University from January 2015 to July 2019.Considering their clinical data,these patients were assigned to four groups.Group A included 34 patients treated by paclitaxel combined with carboplatin intravenous chemotherapy;group B was 30 patients by paclitaxel combined carboplatin intraperitoneal chemotherapy;group C included 28 patients by paclitaxel combined with cisplatin intraperitoneal chemotherapy and group D was intravenous group,including 18 patients treated with traditional chemotherapy drugs(cyclophosphamide,adriamycin,etc.).The effectiveness and safety of carboplatin/paclitaxel intraperitoneal chemotherapy in high-grade serous ovarian cancer(HGSOC)were evaluated by comparing the four groups in the survival rate and side effects.Results:The 5-year survival rate of group A,group B,and group C was significantly higher than that of group D,with statistical difference between each group(P<0.05).The 3-year survival rate of group B and C was also higher than that of group D,with statistical difference between the groups(P<0.05).However,the 3-year and 5-year survival rates between groups A,B,and C showed no statistical difference(P>0.05).The incidence of grade Ⅲ、Ⅳ bone marrow suppression was the highest in group D without significant difference among the four groups(P>0.05).The incidence of grade Ⅲ、Ⅳ gastrointestinal reactions and abdominal pain was significantly different(P<0.05),but with no difference either between group A and group B or between group C and group D(P>0.05).And there was no significant difference in the incidence of rash among the four groups(P>0.05).Conclusion:Compared with cisplatin,carboplatin combined with paclitaxel intraperitoneal chemotherapy can prolong the survival time of patients with HGSOC,improve the treatment effectiveness and have fewer side effects,which can provide reference for future clinical chemotherapy.