摘要
目的观察新辅助化疗(NACT)配合间隔减瘤术(IDS)及术后化疗方案与直接肿瘤细胞减灭术(PDS)配合术后化疗方案治疗FIGOⅢ~Ⅳ期卵巢上皮性癌的疗效及对患者生存影响的差异。方法回顾性分析2017年1月—2021年6月厦门大学附属第一医院收治的89例EOC患者临床资料,根据治疗方案不同分为联合组(48例)和对照组(41例)。联合组予NACT+IDS+术后化疗方案,对照组予PDS+术后化疗方案。观察联合组NACT结束后的近期疗效;比较2组手术相关指标(术中出血量、手术时间以及理想手术、结直肠切除与术后并发症发生率等)与生存情况(治疗结束后1年、2年、3年生存率及平均PFS、OS)。结果联合组NACT近期疗效ORR为43.75%。胸腹水有效控制16例(84.21%)。联合组减瘤术中出血量、平均手术时间均显著少于对照组(P<0.01);联合组NACT结束后达到理想手术率高于对照组(70.83%vs.48.78%,χ2=4.507,P=0.034);联合组结直肠切除率及术后并发症发生率均低于对照组(P<0.05);2组治疗结束后1年、2年、3年生存率及平均PFS、OS比较差异均无统计学意义(P>0.05);2组PFS分布(χ2=0.100,P=0.752)、OS分布(χ2=3.459,P=0.063)差异均无统计学意义。结论FIGOⅢ~Ⅳ期EOC患者行NACT+IDS+术后化疗方案能降低肿瘤负荷,改善近期疗效,提高减瘤术切除质量并减少术后并发症。
Objective To compare the outcomes and survival benefits of a neoadjuvant chemotherapy and interval debulking surgery regimen followed by adjuvant chemotherapy versus a primary debulking surgery and adjuvant chemotherapy regimen in women with advanced(FIGO stageⅢ-Ⅳ)epithelial ovarian cancer.Methods A retrospective analysis was conducted on the clinical data of 89 epithelial ovarian cancer(EOC)patients admitted to the First Affiliated Hospital of Xiamen University from January 2017 to June 2021.Based on different treatment regimens,patients were divided into a combined group(48 cases)and a control group(41 cases).The combined group received neoadjuvant chemotherapy(NACT)followed by interval debulking surgery(IDS)and postoperative chemotherapy,while the control group received primary debulking surgery(PDS)followed by postoperative chemotherapy.The short-term efficacy of the combined group after NACT was observed.The two groups were compared in terms of surgical-related indicators(intraoperative blood loss,operative time,optimal cytoreduction,colorectal resection,and postoperative complication rates)and survival outcomes(1-year,2-year,and 3-year survival rates,as well as mean PFS and OS).Results The overall response rate(ORR)of the combined group after neoadjuvant chemotherapy(NACT)was 43.75%.Thoracic and abdominal ascites were effectively controlled in 16 patients(84.21%).The combined group had significantly less intraoperative blood loss and shorter mean operative time compared with the control group(P<0.01).The rate of optimal cytoreduction after NACT completion was significantly higher in the combined group than in the control group(70.83%vs.48.78%,χ2=4.507,P=0.034).The rates of colorectal resection and postoperative complications were lower in the combined group compared to the control group(P<0.05).There were no statistically significant differences between the two groups in 1-year,2-year,and 3-year survival rates,as well as mean PFS and OS(P>0.05).There were also no statistically significant differences i
作者
林明娟
LIN Mingjuan(The First Affiliated Hospital of Xiamen University,Fujian Province,Xiamen 361000,China)
出处
《临床合理用药杂志》
2024年第35期32-35,共4页
Chinese Journal of Clinical Rational Drug Use
基金
福建省卫健委科技计划项目(2021CXB041)。
关键词
卵巢上皮性癌
新辅助化疗
间隔减瘤术
直接肿瘤减灭术
生存时间
Epithelial ovarian cancer
Neoadjuvant chemotherapy
Interval debulking surgery
Primary debulking surgery
Survival time
