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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。
BACKGROUND & OBJECTIVE: About 70% of patients with ovarian epithelial cancer are diagnosed as advanced stage. At present, the 5-year disease free survival (DFS) after ovariectomy is about 10% According to the characteristics of ovarian cancer, reference to the principles of tumor cell kinetics and oncology pharmacology, three-step chemotherapy was designed to improve the 5-year DFS of patients with stage III-C and IV ovarian cancer. Methods: The study group (group A, n = 15) was given 3-step chemotherapy (paclitaxel + carboplatin once every 3 weeks for 6 to 8 cycles; etoposide plus cyclophosphamide every 4 weeks (B group, n = 51) were retrospectively analyzed in 2007 Affiliated Tumor Hospital of Fudan University The patients with stage Ⅲ C and Ⅳ ovarian cancer who received clinical remission by standard first-line chemotherapy (paclitaxel + carboplatin, once every 3 weeks for 6 to 8 cycles) were enrolled in the Department of Gynecology. The 5-year DFS was compared between the two groups. Results: The 5-year DFS was 80% (12/15) in group A and 5.9% (3/51) in group B, the difference was statistically significant (P <0.01). Conclusion: Three-stage chemotherapy can improve DFS after 5 years in patients with stage Ⅲ C and Ⅳ ovarian cancer after satisfactory cytoreductive surgery. The program has good curative effect, light adverse reactions and low cost of treatment, so it is worth further clinical research.