新辅助化疗联合肿瘤细胞减灭术治疗晚期上皮性卵巢癌的随访观察

发布时间：2018-06-12 15:55

本文选题：新辅助化疗 + 肿瘤细胞减灭术　；参考：《实用妇产科杂志》2017年01期

【摘要】：目的:新辅助化疗(NACT)联合肿瘤细胞减灭术治疗晚期上皮性卵巢癌的随访观察。方法:将纳入研究的128例晚期上皮性卵巢癌依据术前评估能否进行理想细胞减灭术分为观察组(67例)和对照组(61例),观察组无法进行理想细胞减灭术,故先给予NACT,之后行肿瘤细胞减灭及常规化疗;对照组可进行理想细胞减灭术,给予肿瘤细胞减灭术及常规化疗。6~8个化疗周期后观察两组患者疗效以及人附睾分泌蛋白4(HE4)、糖类多肽抗原125(CA_(125))变化,随访3年统计生存率及复查HE4、CA_(125)。结果:观察组总有效率71.64%,对照组总有效率41.79%,两组总有效率比较差异有统计学意义(χ~2=8.7704,P0.05)。治疗后,两组HE4、CA_(125)均较本组治疗前明显下降(P0.05),且观察组下降幅度更大,两组治疗后各指标比较差异均有统计学意义(P0.05)。随访1年,观察组生存率89.55%(60/67),对照组生存率80.33%(49/61),两组比较差异无统计学意义(χ~2=2.1494,P0.05),但两组HE4、CA_(125)水平差异有统计学意义(P0.05)。随访3年,观察组生存率73.13%(49/67),对照组生存率50.75%(34/61),差异有统计学意义(χ~2=4.2389,P0.05),两组HE4、CA_(125)水平差异也有统计学意义(P0.05)。结论:NACT联合肿瘤细胞减灭术可提高晚期上皮性卵巢癌的临床疗效,有助于改善患者预后。
[Abstract]:Objective: to study the effect of neoadjuvant chemotherapy combined with tumor cell reduction in the treatment of advanced epithelial ovarian cancer. Methods: 128 cases of advanced epithelial ovarian cancer were divided into two groups according to the preoperative evaluation: 67 cases in the observation group and 61 cases in the control group. Therefore, NACTs were given first, then tumor cells were reduced and conventional chemotherapy was performed, while the control group was treated with ideal cytoreductive surgery. After tumor cell reduction and conventional chemotherapy for 6 ~ 8 cycles, the curative effect and the changes of human epididymal secretory protein (4HE4) and carbohydrate polypeptide antigen (125) were observed. The survival rate of 3 years follow-up and the reexamination of HE4 / CASP were observed. Results: the total effective rate was 71.64 in the observation group and 41.79 in the control group. The difference between the two groups in the total effective rate was statistically significant (蠂 ~ 2 = 8.7704, P 0.05). After treatment, the two groups were significantly lower than those before treatment (P 0.05), and the range of the observation group was larger than that of the control group. There were significant differences in each index after treatment between the two groups (P 0.05). After one year follow-up, the survival rate of the observation group was 89.55 / 67.The survival rate of the control group was 80.33 / 61g / 49. There was no significant difference between the two groups (蠂 ~ (2 +) 2.1494 ~ (4) P 0.05), but the difference between the two groups was statistically significant (P < 0.05). After 3 years follow-up, the survival rate of the observation group was 73.13 / 67.The survival rate of the control group was 50.75 / 61g / 34 / 61g, and the difference was statistically significant (蠂 ~ (24.2389) P 0.05), and the difference between the two groups was also statistically significant (P 0.05). ConclusionThe combination of tumor cell reduction with 10% NACT can improve the clinical efficacy of advanced epithelial ovarian cancer and improve the prognosis of the patients.
【作者单位】：武警浙江省总队嘉兴医院;同济大学附属同济医院;
【分类号】：R737.31

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