紫杉醇静脉化疗联合卡铂腹腔化疗在卵巢癌术后早期治疗中的应用

目的 探讨上皮性卵巢癌患者术后早期应用紫杉醇静脉化疗联合卡铂腹腔化疗同步双途径化疗的有效性及安全性.方法 2007年3月至2009年6月住院初次治疗为手术治疗的37例上皮性卵巢癌患者在术后l周即开始早期化疗,21例(A组)静脉滴注紫杉醇175 mg/m2,同时腹腔内应用卡铂400 mg,每2周为1个疗程,术后1个月内共完成2个疗程；16例(B组)应用紫杉醇90mg+卡铂200 mg行腹腔化疗,每周1个疗程,术后1个月内共完成3个疗程.结果 37例患者均未出现明显的外周血白细胞下降和肝功能异常.比较化疗后CA125下降情况,A组的总有效率为90.5％( 19/21),B组的总有效率为62.5％( 10/16),差异有统计学意义(P＜0.05).以CA125半衰期＞3周者与CA125半衰期≤3周者比较,A组的化疗有效率为85.7％( 18/21),B组的化疗有效率为56.3％(9/16),差异有统计学意义(P＜0.05).CA125半衰期＞3周者2年复发率为40.0％ (4/10),明显高于CA125半衰期≤3周者11.1％ (3/27),P＜0.05].结论 紫杉醇静脉化疗联合卡铂腹腔化疗用于上皮性卵巢癌患者术后早期治疗安全有效,可改善患者的预后.

Concurrent chemotherapy with the intravenous paclitaxel and intraperitoneal carboplatin routes for the early-stage of postoperative epithelial ovarian cancer

Objective To assess the efficacy and safety of concurrent chemotherapy by the intravenous (ⅣV) paclitaxel and intraperitoneal (IP) carboplatin routes for the early-stage of postoperative for epithelial ovarian cancer.Methods Between March 2007 and June 2009,37 patients of epithelial ovarian cancer treated with primary surgery received chemotherapy at 1 week of postoperative.Twenty-one patients (group A) received concurrent chemotherapy with paclitaxel at 175 mg/m2,immediately followed by carboplatin.16 patients ( B group) received combination of paclitaxel and carboplatin.Results No significant leucopoenia and liver dysfunction were observed.The overall utility rate of serum CA125 decrease in group A (90.5％,19/21 ) was significantly higher than that in group B (62.5％,10/16) (P ＜0.05).The response rate according to the half life of CA125 ≤3 weeks was 85.7％ (18/21) in group A,and was obviously higher than that in group B (56.3％,9/16) (P＜0.05).The two years recurrence rate in the patients of the half life of CA125 ＞3 weeks was 40.0％ (4/10),and was significantly higher than that in the patients of the half life of CA 125 ≤ 3 weeks ( 11.1％,3/27) (P ＜ 0.05 ).Conclusion Concurrent chemotherapy with the Ⅳ paclitaxel and IP carboplatin routes is effective and safe in the early-stage of postoperative epithelial ovarian cancer,and helps improve the patient's prognosis.