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目的:本研究旨在探讨顺铂联合多西他赛的新辅助化疗在晚期卵巢上皮癌治疗中的作用。方法:2005年1月—2012年7月共98例晚期卵巢上皮癌患者被随机分成新辅助化疗组(48例)和对照组(即非新辅助化疗组,50例)。新辅助化疗组接受顺铂联合多西他赛的新辅助化疗2个周期后,行肿瘤细胞减灭术,术后继续行该方案化疗6个周期;对照组先行肿瘤细胞减灭术,术后行顺铂联合多西他赛化疗6~8个周期。观察两组患者的平均手术时间、术中出血量、理想的肿瘤细胞减灭术成功率以及化疗不良反应和生存情况。结果:新辅助化疗组的平均手术时间和术中出血量均明显少于对照组(P<0.05),理想的肿瘤细胞减灭术成功率(85.4%)明显高于对照组(48.0%,P<0.001)。新辅助化疗组中位生存期为39个月,中位无进展生存期为27个月;对照组中位生存期为31个月,中位无进展生存期为20个月(12~27个月);两组比较的差异均有统计学意义(P均<0.05)。两组的化疗不良反应相似,差异无统计学意义。结论:顺铂联合多西他赛的新辅助化疗方案治疗晚期卵巢上皮癌患者,可明显降低手术难度,缩短手术时间,减少术中出血量,提高理想的肿瘤细胞减灭术成功率,并改善患者的预后。
OBJECTIVE: This study was designed to investigate the role of neoadjuvant chemotherapy with cisplatin plus docetaxel in the treatment of advanced epithelial ovarian cancer. METHODS: A total of 98 patients with advanced epithelial ovarian cancer from January 2005 to July 2012 were randomly divided into neoadjuvant chemotherapy group (48 cases) and control group (nontoxic adjuvant chemotherapy group, 50 cases). Neoadjuvant chemotherapy group received cisplatin combined with docetaxel neoadjuvant chemotherapy after 2 cycles of tumor cytoreductive surgery, the continued follow-up of the program after 6 cycles of chemotherapy; control group first tumor cytoreductive surgery, postoperative Cisplatin combined docetaxel chemotherapy 6 to 8 cycles. The mean operative time, intraoperative blood loss, ideal success rate of cytoreductive surgery and adverse reactions and survival of chemotherapy were observed. Results: The average operation time and intraoperative blood loss of the neoadjuvant chemotherapy group were significantly less than those of the control group (P <0.05). The ideal success rate of cytoreductive surgery (85.4%) was significantly higher than that of the control group (48.0%, P <0.001). The neoadjuvant chemotherapy group had a median survival of 39 months and a median progression-free survival of 27 months. The control group had a median survival of 31 months and a median progression-free survival of 20 months (12 to 27 Month). The differences between the two groups were statistically significant (all P <0.05). The two groups of similar adverse reactions, the difference was not statistically significant. Conclusion: The combination of cisplatin and docetaxel neoadjuvant chemotherapy regimen in patients with advanced epithelial ovarian cancer can significantly reduce the difficulty of operation, shorten the operation time, reduce the amount of intraoperative bleeding, improve the success rate of tumor cytoreductive surgery and improve The patient’s prognosis.