复发及持续进展性卵巢癌补救化疗临床分析.docVIP

复发及持续进展性卵巢癌补救化疗临床分析 作者：饶燕,李庭芳 单位：新疆医科大学附属肿瘤医院妇外四科， 新疆乌鲁木齐 【摘要】 目的: 探讨复发及持续进展性卵巢癌二线补救化疗的近期疗效及其影响因素。方法:选择69例接受二线补救化疗的复发及持续进展性卵巢癌患者，20例采用顺铂+异环磷酰胺+足叶乙甙方案，39例采用用紫杉醇＋铂类（顺铂、卡铂或草酸铂）方案，10例采用拓扑替康＋顺铂方案。结果:3种二线化疗方案之间的疗效及骨髓抑制均无明显差异（Pgt;0.05）；接受再次肿瘤细胞减灭术(secondary cytoreductive surgery,SCRS)与未接受SCRS者二线补救化疗疗效差异有统计学意义（Plt;0.05）。结论:复发及持续进展性卵巢癌患者接受二线补救化疗有一定疗效，对铂类耐药的卵巢癌患者，再次接受联合铂类的二线补救化疗仍有一定疗效；二线补救化疗方案之间无优劣；SCRS可以改善二线补救化疗的疗效。 【关键词】 恶性肿瘤 卵巢上皮癌 补救性化疗 　　Clinical analysis of salvage chemotherapy in recurrent and progressing sequentially ovarian carcinoma　　RAO Yan, LI Ting-fang　　(Department of Gynaecologial Oncology, Affiliated Tumor Hospital, Xinjiang Medical University, Urumqi 830011, China) 　　Abstract: Objiection: To evaluate the curative effect of second-line and salvage chemotherapy in recurrent and progressing sequentially ovarian carcinoma in the near future and the influence of their effects. Methods: Clinical data in 69 cases of ovarian carcinoma, who accepted second-line chemotherapy in our hospital, was analyzed retrospectively. Among them, 20 patients received salvage chemotherapy with cisplatin, ifosfamide and etoposide, 39 patients with paclitaxel and platinum category and 10 patients with topotecan-cisplatin. Results: The curative effects were same among three specific chemotherapy projects, among three specific chemotherapy projects in platinum- sensitivity or platinum-resistence （Pgt;0.05). The medullary restraint was not different among three projects （Pgt;0.05). The distinction was in the curative effects between accepting secondary cytoreductive surgery (SCRS) and unaccepting SCRS (Fisherrsquo;s Exact Test: Plt;0.05). Conclusion: Second-line chemotherapy takes some effects in recurrent and progress sequentially ovarian carcinoma. There is not best among second-line chemotherapy. And that the measure of SCRS could improve the curative effect of second-line chemotherapy. 　　Key words: malignant tumor； ovarian carcinoma； salvage chemotherapy 　　卵巢癌病死率居妇科恶性肿瘤首位，复发是其主要原因［1］。因