中国癌症杂志 ›› 2013, Vol. 23 ›› Issue (12): 980-983.doi: 10.3969/j.issn.1007-3969.2013.12.008

• 论著 • 上一篇    下一篇

晚期卵巢癌(ⅢC/Ⅳ期)术后3步化疗法——附15例分析

蔡树模,汤洁,黄啸,黄晓炜,刘素萍   

  1. 复旦大学附属肿瘤医院妇瘤科,复旦大学上海医学院肿瘤学系,上海 200032
  • 出版日期:2013-12-30 发布日期:2014-02-17
  • 通信作者: 蔡树模 E-mail:Rt3cai56@163.com

Three-step chemotherapy after primary debulking surgery in 15 patients with stage Ⅲc or Ⅳovarian cancer

CAI Shu-mo,TANG Jie,HUANG Xiao,HUANG Xiao-wei,LIU Su-ping   

  1. Department of Gynecologic Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College Fudan University, Shanghai 200032, China
  • Published:2013-12-30 Online:2014-02-17
  • Contact: CAI Shu-mo E-mail: Rt3cai56@163.com

摘要: 背景与目的:卵巢上皮癌确诊时约70%以上属晚期,目前ⅢC、Ⅳ期卵巢癌术后经一线标准化疗后,其5年无病生存率(disease free survival,DFS)约10%,本研究根据卵巢癌的特点,参考肿瘤细胞动力学和肿瘤药理学的原理,设计3步化疗法,以期提高ⅢC、Ⅳ期卵巢癌患者5年DFS。方法:研究组(A组,n=15)给予3步化疗法(紫杉醇+卡铂,每3周给药1次,共6~8个周期;依托泊甙+环磷酰胺,每4周给药1次,共6个周期;卡铂+环磷酰胺,每8周给药1次,共6个周期)治疗,对照组(B组,n=51)回顾分析2007年复旦大学附属肿瘤医院妇瘤科收治的ⅢC、Ⅳ期卵巢癌经标准一线化疗获临床缓解的患者(紫杉醇+卡铂,每3周给药1次,共6~8个周期),比较2组5年DFS。结果:A组5年DFS为80%(12/15),B组为5.9%(3/51),差异有统计学意义(P<0.01)。结论:对ⅢC、Ⅳ期卵巢癌在满意细胞减灭术后,采用3步化疗法能提高5年DFS。该方案疗效好,不良反应轻,治疗费用低,值得进一步开展临床研究。

关键词: 卵巢癌, 肿瘤细胞减灭术, 化疗

Abstract: Background and purpose: More than 70 percent of ovarian cancer patients were diagnosed in the advanced stage. Currently the 5-year disease free survival (DFS) of stage ⅢC-Ⅳ ovarian cancer patients wsa about 10 percent after first line chemotherapy. This study aimed to improve the 5-year DFS by three-step chemotherapy according to the mechanisms of ovarian cancer biological characteristics, cytodynamics and pharmacology. Methods: In arm A, the patients received three-step chemotherapy after primary debulking surgery, step one with paclitaxel plus carboplatin (TC regimen), every 3 weeks for 6 to 8 cycles; step two with etoposide plus cyclophosphamide, every 4 weeks for 6 cycles; step three wit carboplatin plus cyclophosphamide every eight weeks for six cycles. In control arm B, we retrospectively analysed 51 cases with ⅢC-Ⅳ stage ovarian cancer, who had completely response after standard chemotherapy with six to eight cycles of TC after primary surgery during 2007. We compared the 5-year DFS between the two arms. Results: The 5-year DFS of 15 cases in arm A was 80%(12/15), which was significantly higher than that of arm B (5.9%, 3/51, P<0.01). Conclusion: The three-step chemotherapy after optimal debulking surgery in stage ⅢC-Ⅳ can improve the 5-year DFS. This regimen is high efficacy, mild side-effect witn low cost, which deserves further exploration.

Key words: Ovarian cancer, Cytoreductive surgery, Chemotherapy