巩固性腹腔内卡铂化疗对临床完全缓解卵巢癌的治疗价值

Intraperitoneal carboplatin chemotherapy on ovarian carcinoma being clinically in complete remission

目的 探讨巩固性腹腔卡铂化疗对临床完全缓解 (CCR)卵巢癌的治疗价值。方法 选择经全身联合化疗达 CCR的卵巢癌患者 98例 ,随机分为联合化疗组 6 7例 ,腹腔化疗 31例 ,前者继续按原化疗方法化疗三个周期 ,后者行腹腔内卡铂化疗。结果 化疗前 ,有 2 5例行二次探查术 (SL L) ,17例阴性 ,8例阳性 ,31例腹腔内卡铂化疗者 2、3、4、5年生存率分别为 90 .3%、6 1.2 %、5 1.6 %和 45 .2 %,中位生存期和无复发生存期分别为 5 1.5个月和 31.8个月。 SL L阴性和阳性者经化疗后 2、3、4、5年生存率分别为 94.1%、82 .3%、6 4.7%、5 8.8%和87.5 %、5 0 .0 %、37.5 %、12 .5 %,中位生存期为 6 8.5月和 2 9.5月 ,无复发生存期为 41月和 2 1月。 SL L阴性和阳性者 5年生存率、中位生存期、无复发生存期间均有显著性差异 (P均 <0 .0 0 1)。联合化疗组 ,其 2、3、4、5年生存率分别为 88.1%、6 1.2 %、43.3%、32 .8%,中位生存期和无复发生存期分别为 39.2个月和 18.7个月 ,与腹腔化疗者 5年生存率、中位生存期和无复发生存期有显著性差异 (P分别 <0 .0 1、0 .0 5、0 .0 0 1)。结论 对 CCR卵巢癌患者行短期卡铂腹腔内化疗是有益的。

Objective To investigate the value of short-term intraperitoneal carboplatin chemotherapy on ovarian carcinoma patients who were clinically in complete remission.Methods 98 cases of ovarian carcinoma who were clinically in complete remission after completion of post-operative systemic chemotherapy were inrolled.3 courses of intraperitoneal chemotherapy were administered to 31 cases,of which 25 cases underwent second-look laparotomy (SLL)before intraperitoneal chemotherapy,17 cases were pathologically complete remission (PCR),in the others,5 macroscopically positive second-look,3 microscopically positive second-look.Results The 2,3,4,5year survival rate of the SLL negative group and positive group were 94.1%,82.3%,64.7%,58.8% and 87.5%,50.0%,37.5%,12.5%, respectively.The median survival time and the progression-free interval(PFI) in SLL negative and positive group were 68.5,41 and 29.5,21 months(P<0.001).All patients who received intraperitoneal carboplatin,the 2,3,4,5year survival rate median survival time and PFI were 90.3%,62.2%,51.6%,45.0%,51.5% months and 31.8 months.67 cases received systemic combined chemotherapy after complete remission for 3 courses.The 2,3,4,5 year survival rate were 88.1%,61.2%,43.3%,32.8%.The median survival time and PFI were 39.2 and 18.7 months,respectively.The 5 year survival rate,median survival time,duration of PFI of the intraperioneal carboplatin chemotherapy group were much better than the systemic treated one (P<0.05).Conclusion Short-term intraperitoneal carboplatin chemotherapy should be considered for consolidation of treatment in ovarian carcinoma patients who are clinically in complete remission.