摘要
目的探讨肿瘤细胞减灭术(CRS)联合腹腔热灌注顺铂化疗(HIPEC)对晚期子宫内膜癌患者预后的影响。方法回顾性分析2011年5月-2014年5月唐山市人民医院收治的63例初治或复发性晚期子宫内膜癌患者,均行肿瘤细胞减灭术,术后辅助单纯化疗、单纯放疗或化疗联合放射治疗,其中35例患者术后一周内行腹腔热灌注治疗,28例患者未行腹腔热灌注治疗,对二组患者进行随访观察5年,比较二组患者的术后无进展生存时间(PFS)及总生存期(OS)。结果腹腔热灌注组患者的5年PFS和OS显著高于非腹腔热灌注组(P<0.05)。单因素分析显示,子宫内膜癌FIGO分期、病理类型、残留病灶大小、术后辅助治疗、化疗疗程数、腹腔播散情况、是否HIPEC治疗等均为患者预后的影响因素(P<0.05),将以上有统计学意义的单因素分析结果应用COX多因素分析,结果显示腹腔热灌注顺铂是晚期盆腹腔转移的子宫内膜癌患者预后的独立保护因素(P<0.05)。分层分析结果显示,Ⅲ期及Ⅳ期子宫内膜癌患者中应用HIPEC组的5年PFS及OS均较未应用组明显延长,且差异有统计学意义,COX多因素分析中显示,应用HIPEC在对Ⅲ期及Ⅳ期患者的预后影响中均为独立保护因素。结论采用肿瘤细胞减灭术联合腹腔热灌注顺铂治疗晚期子宫内膜癌患者,可以有效改善预后,提高治疗效果。
Objective To investigate the effect of cytoreductive surgery(CRS) combined with hyper thermic intraperitoneal chemotherapy(HIPEC) of cisplatin on the prognosis of patients with advanced endometrial cancer.Methods A retrospective analysis was performed on sixty-three patients with primary or recurrent advanced endometrial cancer from May 2011 to May 2014 in Tangshan People′s Hospital.All patients were treated with cytoreductive surgery,postoperative adjuvant chemotherapy alone,radiotherapy alone or chemotherapy combined with radiotherapy.Among them,35 patients were treated with intraperitoneal hyperthermia within one week after operation,28 patients were not treated with intraperitoneal hyperthermia.Patients in the two groups were followed up for 5 years,and the progression-free survival time(PFS) and total survival time(OS) of the patients were compared.Results The 5-year PFS and OS of the patients in the intraperitoneal heat perfusion group were significantly higher than those in the non-intraperitoneal heat perfusion group(P<0.05).The single factor analysis showed that the FIGO stage of endometrial cancer,pathological type,size of remained tumor,postoperative adjuvant therapy,number of chemotherapy treatment,intraperitoneal dissemination and treatment of hyper thermic intraperitoneal chemotherapy of cisplatin were all influencing factors of 5-year PFS and OS in patients(P<0.05).Univariate analysis results with statistical significance were applied to COX multivariate analysis,and the results showed that HIPEC of cisplatin was an independent protective factor for the prognosis of patients with advanced pelvic and peritoneal metastatic endometrial cancer(P<0.05).Stratified analysis results showed that 5-year PFS and OS of the HIPEC group in patients with stage Ⅲand Ⅳ endometrial cancer were significantly longer than those in the untreated group,with statistical significance.COX multivariate analysis showed that HIPEC was an independent protective factor in the prognostic of patients with stage Ⅲ and stage
作者
左卫微
马国明
王爱芹
薛书霞
郭淑红
王晓敏
Zuo Weiwei;Ma Guoming;Wang Aiqin(Obstetrics and Gynecology Department,Tangshan Peoples Hospital,Tangshan 063000,China)
出处
《中国煤炭工业医学杂志》
2020年第2期154-159,共6页
Chinese Journal of Coal Industry Medicine
基金
2018年度河北省医学科学研究重点课题计划(编号:20181214)。
关键词
晚期子宫内膜癌
腹腔热灌注
顺铂
肿瘤细胞减灭术
预后
Advanced endometrial cancer
Hyper thermic intraperitoneal chemotherapy
Cisplatin
Cytoreductive surgery
Prognosis
