影响复发上皮性卵巢癌化疗疗效的临床病理因素分析

目的:分析影响铂类敏感型及耐药型复发上皮性卵巢癌(EOC)患者预后的相关临床病理因素。方法:回顾分析1985年1月至2011年11月广西医科大学附属肿瘤医院收治的复发EOC患者83例,其中铂类敏感型56例,耐药型27例。采用Kaplan-meier生存率曲线、Log-rank test检验和Cox模型多因素回归分析法分析影响复发EOC患者预后的相关因素。结果:(1)铂类敏感型复发EOC患者的中位无进展生存期(PFS)为11个月(95%CI 9.105～12.895),中位总生存期(OS)为16个月(95%CI 13.144～18.856);铂类耐药型复发EOC患者的中位PFS为8个月(95%CI 4.219～11.781),中位OS为10个月(95%CI 3.824～16.176)。(2)复发后伴有腹水、复发后化疗方案、化疗疗程、化疗效果是影响敏感型复发EOC患者的重要预后因素(P<0.05);无复发生存时间(RFS)、复发后伴有腹水、复发部位、化疗效果是影响耐药型复发EOC患者的重要预后因素(P<0.05)。(3)复发后化疗疗程数、复发后伴有腹水、化疗疗效是影响敏感型复发EOC患者预后的独立危险因素,而复发部位是影响耐药型复发EOC患者预后的独立危险因素。结论:铂类敏感型患者复发后宜选择与一线类似的铂类联合方案化疗,并尽可能化疗至6疗程。复发病灶位于盆腹腔是影响耐药型患者预后的独立危险因素,应积极治疗。

The analysis of clinicopathological factors in the therapeutics effect of chemotherapy for recurrent epithelial ovarian cancer

Objective：To analyze the impact of clinicopathologieal factors in prognosis of recurrent platinum-sensitive and platinum resistant epithelial ovarian cancer （ EOC ）. Methods：83 recurrent EOC cases （56 platinum-sensitive and 27 platinum-resistance cases） treated at the Department of Gynecologic Oncology of Affiliated Cancer Hospital of Guangxi Medical U- niversity from Jan. 1985 to Nov. 2011 were retrospectively reviewed. Kaplan-meier survival curves,Log-rank test and Cox multivariate test regression were used to analyze clinical and pathological prognostic factors of recurrent EOC. Results： （ 1 ） The median progress-free survival （PFS） of 56 platinum-sensitive recurrent EOC cases was 11 months（95% CI 9. 105 N 12. 895） and the median overall survival （OS） time was 16 months（95% CI 13. 144 - 18. 856）. The median PFS of 27 platinum-resistance recurrent EOC cases was 8 m0nths（95% CI 4. 219 - 11. 781 ）and the median OS was 10 months （95 % CI 3. 824 -16. 176）. （2）Courses of chemotherapy, relapse with ascites, the efficacy of chemotherapy were factors which had important impact on prognosis of recurrent EOC that was platinum-sensitive （p〈o. 05 ）. Relapse Free Survival （RFS） time, relapse with ascites, recurrence site, the efficacy of chemotherapy impact on prog- nosis of platinum-resistance recurrent EOC （ P〈0.05 ）. （3） Courses of chemotherapy after replapse, relapse with ascites, the efficacy of chemotherapy were independant risk factors for platinum-sensitive recurrent EOC, recurrence site was the only independent prognostic risk factor for platinum-resistance recurrent EOC. Conclusion： It is appropriate to choose platinum-base chemotherapy regiments for platinum-sensitive EOC and encourage the patients to finish 6 courses of chemotherapy. Active treatment should be given to platinum resistent recurrent EOC with peritoneal and pelvic recurrent lesions.