摘要
目的探讨腹腔热灌注化疗(IPHC)治疗晚期卵巢上皮性肿瘤(OET)的疗效及对预后的影响。方法收集90例晚期OET患者的临床资料,所有患者均接受卵巢癌细胞减灭术。根据治疗方法的不同将患者分为对照组(n=42)和观察组(n=48),对照组患者术后接受静脉化疗,观察组患者术后接受静脉化疗和IPHC。比较两组患者术前和各次(第1次、第2次、第3次、第4次)化疗后的血清糖类抗原125(CA125)水平、治疗过程中的不良反应、治疗后腹腔积液控制情况。采用Kaplan-Meier法绘制生存曲线,比较两组患者的3年无进展生存情况。结果两组患者的血清CA125水平均于化疗后逐渐降低,时间和组别间存在交互效应(P﹤0.05)。术前和第4次化疗后,两组患者的血清CA125水平比较,差异均无统计学意义(P﹥0.05)。第1次、第2次和第3次化疗后,观察组患者的血清CA125水平均低于对照组,差异均有统计学意义(P﹤0.05)。两组患者3级以上胃肠道反应、骨髓抑制、肝肾功能不全、周围神经损伤的发生率及不良反应总发生率比较,差异均无统计学意义(P﹥0.05)。观察组患者腹腔积液控制总有效率为93.75%,高于对照组的78.57%,差异有统计学意义(P﹤0.05)。观察组患者的3年无进展生存率为43.8%,高于对照组的26.2%,差异有统计学意义(P﹤0.05)。结论 IPHC对晚期OET患者的腹腔积液控制满意,可延长患者的无进展生存时间,且不增加化疗不良反应,值得临床推广应用。
Objective To investigate the curative effect of intraperitoneal hyperthermic chemotherapy (IPHC) in advanced ovarian epithelial tumor (OET),and to determine the influence on prognosis.Method The clinical data of 90 cases with advanced OET who were treated with cytoreductive surgery was collected.According to different treatment delivered, patients were stratified as control group (n=42) and study group (n=48),the control group was given intravenous chemotherapy,and the study group was administered with intravenous chemotherapy in combination with IPHC.The serum carbohydrate antigen 125 (CA125) level before and after each treatment (first to fourth dose),adverse reactions during treatment and ascites management were compared between the two groups.Survival curves were plotted using Kaplan- Meier method,the 3-year progression-free survival (PFS) rates were compared between the two groups of patients. Result The level of serum CA125 decreased consistently in both groups after chemotherapy,and there was an interactive effect observed between time and group (P<0.05).The serum CA125 level before chemotherapy and after 4th dose in the two groups did not differ significantly (P>0.05).After 1^st,2^nd and 3^rd dose,the serum level of CA125 in study group were evidently lower compared with control group (P<0.05).And there were no significant differences regarding the incidence of gastrointestinal reactions,bone marrow suppression,hepatic and renal insufficiency,peripheral nerve injury,and overall adverse reaction rates between the two groups (P>0.05).The overall control rate for ascites in study group was 93.75%,which was significantly higher than that in control group at 78.57%,with statistically significant difference observed (P<0.05).The 3-year PFS rate in study group was 43.8%,and it was significantly higher than the 26.2% in control group,showing statistically significant difference (P<0.05).Conclusion IPHC can effectively control the ascites in advanced OET,extending PFS without increasing the adverse reactions.
作者
牛海燕
侯保萍
卫金线
NIU Haiyan;HOU Baoping;WEI Jinxian(Department of Gynecology,Zhengzhou First People’s Hospital,Zhengzhou 450000,He’nan,China)
出处
《癌症进展》
2019年第7期823-826,共4页
Oncology Progress
关键词
腹腔热灌注化疗
卵巢上皮性肿瘤
疗效
预后
intraperitoneal hyperthermic chemotherapy
ovarian epithelial tumor
curative effect
prognosis
作者简介
通信作者(corresponding author):牛海燕,邮箱:350729191@qq.com.
