新辅助化疗在晚期卵巢癌治疗中的作用研究

发布时间：2018-06-24 12:33

本文选题：晚期卵巢癌 + 新辅助化疗　；参考：《延边大学》2017年硕士论文

【摘要】：目的:分析新辅助化疗治疗晚期卵巢癌的临床疗效,评价新辅助化疗在晚期卵巢癌治疗中的临床意义。方法:收集2005年1月—2015年12月本院妇科治疗的Ⅲ期卵巢癌患者113例,34例采用新辅助化疗结合肿瘤细胞减灭术再延续全程化疗(观察组),79例采用肿瘤细胞减灭术合并术后全程辅助化疗(对照组),比较两组患者的治疗效果及预后,评价新辅助化疗在晚期卵巢癌治疗中的作用及意义。结果:观察组中合并腹水者31例,平均接受2.2个疗程的新辅助化疗后4例腹水消失,22例腹水明显减少,5例无效。初诊时血清CA125平均浓度为(4060.29±313.04)U/ml;接受新辅助化疗1个疗程后为(787.65土79.28)U/ml,与初诊时相比下降了80.60%;接受2个疗程后平均浓度为(329.47±47.57)U/ml,与初诊时相比下降了91.89%;接受3个疗程新辅助化疗的患者共有7例,接受3个疗程后平均浓度为(169.29±17.90)U/ml,与其初诊时的平均值相比下降了95.83%。观察组术后1个月CA125水平为(73.12±19.37)U/ml,显著低于对照组(202.13±49.15)U/ml(P0.05);观察组的理想减灭率为91.2%,显著高于对照组63.3%(P0.05);观察组平均手术时间为(143.76±48.09)min,显著低于对照组(195.19±23.36)min(P0.05);观察组术中平均出血量为(184.85±44.16)ml,显著低于对照组(365.06±60.63)ml(P0.05);观察组术后复发的平均时间为13个月,对照组为17.3个月,二者相比无统计学差异(P0.05);观察组和对照组1年生存率(85.2%和80.0%)、3年生存率(22.2%和29.1%)、5年生存率(18.5%和20.0%)均无统计学差异(均P0.05)。结论:晚期卵巢癌患者术前行新辅助化疗能对肿瘤细胞起到杀伤作用、降低手术的难度、提高手术的成功率、为已经错过最佳手术时机的患者创造机会,但在控制治疗后复发以及提高术后生存率方面无明显优势。
[Abstract]:Objective: to analyze the clinical efficacy of neoadjuvant chemotherapy in the treatment of advanced ovarian cancer and to evaluate the clinical significance of neoadjuvant chemotherapy in the treatment of advanced ovarian cancer. Methods: 113 cases of stage III ovarian cancer were collected from January 2005 to December 2015 in our hospital, and 34 cases were treated with neoadjuvant chemotherapy and followed by tumor cell subtraction and followed by whole course chemotherapy. 79 cases were treated with tumor cell subtraction and postoperative adjuvant chemotherapy (control group), compared the therapeutic effect and prognosis of the two groups, and evaluated the role and significance of the neoadjuvant chemotherapy in the treatment of advanced ovarian cancer. Results: 31 cases were combined with ascites in the observation group, 4 cases of ascites disappeared and 22 cases were abdominal after the average of 2.2 courses of neoadjuvant chemotherapy. The water decreased significantly, 5 cases were ineffective. The mean serum CA125 concentration was (4060.29 + 313.04) U/ml at first diagnosis, and after 1 courses of neoadjuvant chemotherapy (787.65 soil 79.28) U/ml, decreased by 80.60% when compared with the first diagnosis; the average concentration was (329.47 + 47.57) U/ml after the 2 course of treatment, and decreased by the first diagnosis. The average concentration of 7 patients was (169.29 + 17.90) U/ml after 3 courses of treatment. Compared with the average value of the first diagnosis, the level of CA125 in the 95.83%. observation group was (73.12 + 19.37) U/ml, significantly lower than that of the control group (202.13 + 49.15) U/ml (P0.05), and the ideal reduction rate of the observation group was 91.2%, significantly higher than that of the control group (63.3% (P0.05)). The average operation time of the group was (143.76 + 48.09) min, significantly lower than that of the control group (195.19 + 23.36) min (P0.05), and the average bleeding amount in the observation group was (184.85 + 44.16) ml, significantly lower than that of the control group (365.06 + 60.63) ml (P0.05); the average time of postoperative recurrence was 13 months in the observation group and 17.3 months in the control group, and there was no statistical difference (P0.05) compared with the control group (P0.05). The 1 year survival rate (85.2% and 80%), 3 year survival rate (22.2% and 29.1%) and 5 year survival rate (18.5% and 20%) were no significant difference between the control group and the control group (both P0.05). Conclusion: the neoadjuvant chemotherapy in advanced ovarian cancer patients can kill the tumor cells, reduce the difficulty of the operation, improve the success rate of the operation, and have missed the best operation. Opportunity creates opportunities for patients, but has no obvious advantage in controlling recurrence after treatment and improving postoperative survival.
【学位授予单位】：延边大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.31

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