孕激素联合化疗治疗卵巢上皮性癌

目的 分析孕激素联合以铂类为主的常规化疗对卵巢上皮性癌1～4期患者的临床疗效。方法 以已行瘤体减灭术的卵巢上皮性癌患者1～4期为研究对象，分为单纯化疗组、己酸孕酮组和普维拉组。随访、统计各组各期患者的生存率及复发率、血清激素水平、骨密度变化以及化疗副反应。结果 孕激素联合以铂类为主的化疗对早期卵巢上皮性癌的预后无明显影响，但对晚期(3期)卵巢上皮性癌的术后近期以及远期(2～5年)生存率及复发率均有改善趋势。单纯化疗组、己酸孕酮组、普维拉组3期患者术后3年生存率分别为34．8％、66．2％、73．9％，复发率分别为72．2％、47．3％、40．6％；单纯化疗组、己酸孕酮组术后5年生存率分别为17．4％、48．4％，复发率分别为81．5％、62．4％。孕激素的使用不影响患者血清激素水平，也不增加化疗的毒、副作用。联合孕激素治疗的患者术后骨密度下降较一般绝经后妇女慢。结论 孕激素联合以铂类为主的常规化疗可改善晚期卵巢上皮性癌的预后，并且不增加化疗的毒副作用，可改善患者的骨量丢失。

Effect of Progesterone Combined with Chemotherapy on Epithelial Ovarian Cancer

Purpose To analyze the effect of progesterone combined with carboplatinum based chemotherapy on the prognosis of epithelial ovarian cancer patients stage 1 - 4. Methods One hundred and twenty-eight epithelial ovarian cancer patients stage 1-4 who had received debulking surgery were enrolled in the clinical trial. The patients were divided into chemotherapy group,progesterone acetate group and provera group. Relapse,death,serum sex hormone level,bone density and side effects of chemotherapy were followed up. Results Progesterone combined with carboplatinum based chemotherapy had no obvious effect on the prognosis of early stage epithelial ovarian cancer patients compared with those received regular chemotherapy only. But the regimen improved the short term and long term (2 - 5a after surgery) prognosis of advanced (stage 3) epithelial ovarian cancer. There year survival rates of stage 3 patients of the chemotherapy group, progesterone acetate group and provera group were: 34.8%, 66.2%,73.9% respectively; the 3 year recurrence rates were: 72.2 % , 47.3 % , 40. 6 % respectively. The 5 year survival rates of the chemotherapy group and progesterone group were: 17.4% ,48.4% respectively;5 year recurrence rates were:81.5% ,62.4% respectively.The use of progesterone did not affect the serum sex hormone level,neither did it worsen the side effects of regular chemotherapy. The descent of bone density was slow for the patients who used progesterone. Conclusions Progesterone combined with carboplati-num based chemotherapy can improve the prognosis of advanced epithelial ovarian cancer without worsening the side effects of chemotherapy. The use of progesterone can ameliorate the descent of bone density.