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[目的]观察新辅助化疗治疗晚期卵巢癌的疗效和毒副反应。[方法]治疗组37例患者采用新辅助化疗,对照组30例病人不进行新辅助化疗。治疗组患者新辅助化疗1～3个周期后行卵巢癌减瘤术。对照组患者经术前准备后直接进行手术。术后化疗方案两组相同。通过观察疗效、毒副反应、手术时间、术中出血、手术残留、手术并发症等,评价新辅助化疗在卵巢癌治疗中的作用及安全性。[结果]新辅助化疗组的总有效率为91.9(34/37);胸、腹水控制率为94.6(35/37);患者新辅助化疗后Kamofsky评分均有明显提高,毒副反应可耐受。化疗后均进行了广泛性全子宫、双附件、大网膜、阑尾及受累脏器切除术和淋巴清扫术。对照组总有效率为76.7(23/31);胸、腹水控制率为83.3(35/37);患者治疗后Kamofsky评分均有提高,毒副反应可耐受。两组近期疗效比较及胸腹水控制率比较差异均有统计学意义(P=0.040;P=0.037);两组满意肿瘤细胞减灭术比较差异有统计学意义(P=0.01);两组胃肠道反应和骨髓抑制情况不良反应比较差异无统计学意义(P=0.897;P=0.911)。[结论]卵巢癌新辅助化疗是安全有效的,毒副作用轻微。
[Objective] To observe the curative effect and toxicity of neoadjuvant chemotherapy for advanced ovarian cancer. [Method] Thirty-seven patients in the treatment group received neoadjuvant chemotherapy and 30 patients in the control group did not receive neoadjuvant chemotherapy. Neoadjuvant chemotherapy in patients in the treatment group 1 to 3 cycles after ovarian cancer tumor reduction surgery. Patients in the control group underwent surgery directly after preoperative preparation. Postoperative chemotherapy in both groups the same. To evaluate the effect and safety of neoadjuvant chemotherapy in the treatment of ovarian cancer by observing the curative effect, side effects, time of operation, intraoperative bleeding, surgical residual and surgical complications. [Results] The total effective rate of neoadjuvant chemotherapy group was 91.9 (34/37). The control rate of chest and ascites was 94.6 (35/37). The Kamofsky score of patients with neoadjuvant chemotherapy was significantly increased, and the toxicity was tolerable . After chemotherapy were extensive uterine, double attachment, omentum, appendix and affected organ resection and lymph node dissection. The total effective rate of the control group was 76.7 (23/31); the control rate of chest and ascites was 83.3 (35/37); the Kamofsky score of the patients improved and the toxicity was tolerable. There was significant difference between the two groups in short-term curative effect and control rate of pleural effusion and ascites (P = 0.040; P = 0.037). There was significant difference between the two groups in satisfactory cytoreductive surgery (P = 0.01) There was no significant difference in adverse reactions between gut reaction and myelosuppression (P = 0.897; P = 0.911). [Conclusion] Neoadjuvant chemotherapy for ovarian cancer is safe and effective with minor toxicities and side effects.