新辅助化疗在中晚期卵巢癌的应用探讨

目的:探讨新辅助化疗对中晚期卵巢癌患者复发和预后的影响。方法:回顾性分析52例中晚期卵巢癌患者的治疗及预后,32例术前采用全身序贯化疗(standard sequence chemotherapy SSC) 腹腔内灌注化疗2个疗程。术后用DNA原位末端标记检测肿瘤细胞凋亡并随访观察癌复发和生存时间。结果:新辅助化疗组与未术前化疗组肿瘤细胞凋亡数分别为(50.71;3.87)和(29.13;3.69)个?高倍视野,观察组1、3、5年复发率为12.5%(4/32)、25%(8/32)、59.4%(19/32);生存率100%(32/32)、78.1%(25/32)、22%(7/32)。对照组1、3、5年复发率35%(7/20)、45%(9/20)、90%(18/20);生存率80%(16/20)、55%(11/20)、20%(4/20)。3年生存率的比较中,化疗组为25例,明显高于无术前化疗组11例,P<0.05,差异有显著意义。而5年生存率差,P>0.05异则无显著意义。术前化疗组中,腹痛腹胀等症状缓解率为30%,肿块缩小率(PR CR)为62.5%,基本切净率为93%。残留>2cm有2例。无术前化疗组中,基本切净率为85%,残留>2cm有3例,相比,P<0.05,差异有显著意义。结论:新辅助化疗对卵巢癌细胞有明显促凋亡作用,是预防癌复发转移和改善预后的有效手段。

The effect of new assistant chemotherapy in advanced ovarian carcinoma

Objective:The effect of recurrence and prognosis of advanced ovarian carcinoma treated by the new assistant chemotherapy.Methods:The 32 presurgical cases received SSC and celiac chemotherapy,DDP,CTX were infused.The death of tumor cell were tested by DNA terminal method;recurrence and prognosis were analyzed.The other 20 cases,treated by radical resection directly.Results:The 1,3,5-year survival rates in treatment group were 100%,78.1%,22% respectively while in the controe other group were 80%,55%,20%.The difference between the 2 groups was statistically significant(P<0.05).Conclusion:the new assistant chemotherapy was an effective treatment for ovarian carcinoma.