新辅助化疗联合手术治疗晚期卵巢癌近期及远期疗效观察

目的探讨新辅助化疗联合手术治疗在治疗晚期卵巢癌中的作用和疗效。方法选择60例晚期卵巢癌患者作为研究对象，按照不同治疗方法分为两组，30例患者[新辅助化疗组（NACT）组]采用新辅助化疗，然后进行肿瘤减灭术；另外30例患者（对照组）首先行肿瘤减灭术，再行化疗。结果NACT组理想肿瘤减灭率为73．3％，对照组为36．7％，两组比较差异有统计学意义（P〈0．05）；NACT组术中出血量及手术时间较对照组少（短），两组比较差异有统计学意义（P〈0．05）；合并脏器切除率分别为16．7％和20．0％，并发症发生率为13．3％和20．0％，组间比较差异无统计学意义（P〉0．05）；新辅助化疗组的中位生存时间（37月）较先期手术组（30月）长，1年生存率分别为90．0％和83．3％（P〉0．05），3年生存率分别为50．0％和26．7％（P〉0．05）。结论对晚期卵巢癌患者行新辅助化疗有助于提高患者的手术效果和近期生存率，具有较好的临床安全性。

Effect of neoadjuvant chemotherapy combined with operation in advanced ovarian cancer

Objective To investigate the role and efficacy of neoadjuvant chemotherapy combined with surgery in the treatment of advanced ovarian carcinoma.Methods Sixty patients with advanced ovarian carcinoma were selected and divided into two groups according to the different treatment.Thirty patients(neoadjuvant chemotherapy group,NACT) were treated by neoadjuvant chemotherapy,and then by tumor cytoreduction.The other 30 patients(control group) were treated first by tumor cytoreduction and then by neoadjuvant chemotherapy.Results The rate of tumor cytoreduction of NACT group ideally was 73.3%,and 36.7% in control group.There was significant difference between two groups(P<0.05).The bleeding volume was less and operation time was shorter of NACT group than those of control group,and there was significant difference between two groups(P<0.05);en bloc devisceration rates with adjacent organs were 16.7% and 20.0%,and the complication rates were 13.3% and 20.0%,there was no significant difference between two groups(P>0.05).The median survival time of neoadjuvant chemotherapy group(37 months) was longer than the control group(30 months).The 1-,3-year survival rates were 90.0%,50.0% in NACT group and 83.3%,26.7% in control group(P>0.05).Conclusion Neoadjuvant chemotherapy for the treatment of advanced ovarian carcinoma may improve the surgical result and survival rate of patients with good clinical safety.