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目的:探讨紫杉醇加铂类(PT组)和环磷酰胺加铂类(PC组)在卵巢上皮性癌初治患者中的疗效。方法:对1998年1月至2004年1月第四军医大学西京医院和第三军医大学大坪医院收治的78例卵巢上皮性癌术后患者进行回顾性分析,其中PT组36例,PC组42例,比较两组的近期疗效和3年存活率、无进展生存时间以及不良反应。结果:PT和PC方案的患者化疗有效率分别为77.8%和66.7%(P<0.01),中位生存时间分别为29个月和23个月(P<0.01),中位无进展生存时间分别为23个月和15个月(P<0.01),3年存活率分别为41.7%和19.0%(P<0.05)。在早期(Ⅰ期+Ⅱ期)卵巢癌患者中,PT组和PC组中位生存时间和中位无进展生存时间差异无统计学意义,但中晚期(Ⅲ期+Ⅳ期)患者PT组和PC组中位生存时间和中位无进展生存时间分别为25.4月和21.0月以及16.1月和7.9月(P<0.05),有统计学意义,表明PT方案对中晚期患者可能更具有优势。PT组脱发和血液学毒性发生率高于PC组,而消化系统毒性和肝肾功损害发生率低于PC组。结论:卵巢癌的辅助化疗中,PT方案在化疗反应率、无进展生存时间及3年存活率均优于PC方案,对中晚期患者,前者的优势更为显著。
Objective: To investigate the efficacy of paclitaxel plus platinum group (PT group) and cyclophosphamide plus platinum group (PC group) in newly diagnosed ovarian epithelial cancer patients. Methods: A retrospective analysis was performed on 78 patients with epithelial ovarian cancer who underwent surgery between Xijing Hospital of the Fourth Military Medical University and Daping Hospital of the Third Military Medical University from January 1998 to January 2004, in which 36 patients in the PT group and 42 in the PC group Cases, the two groups were compared the short-term efficacy and 3-year survival rate, progression-free survival time and adverse reactions. Results The effective rates of chemotherapy in patients with PT and PC were 77.8% and 66.7%, respectively (P <0.01). The median survival time was 29 months and 23 months (P <0.01), and the median progression-free survival time For 23 months and 15 months (P <0.01). The 3-year survival rates were 41.7% and 19.0%, respectively (P <0.05). There were no significant differences in median survival time and median survival time between PT group and PC group in early stage (stage Ⅰ + Ⅱ) ovarian cancer patients. However, PT group and middle stage (stage Ⅲ + Ⅳ) The median survival time and median progression-free survival time in PC group were 25.4 months and 21.0 months and 16.1 months and 7.9 months (P <0.05), respectively, with statistical significance, indicating that the PT regimen may be more advantageous for advanced stage patients. The incidence of alopecia and hematological toxicity in PT group was higher than that in PC group, while the incidence of digestive system toxicity and liver and kidney damage was lower than that in PC group. Conclusion: Among the adjuvant chemotherapy for ovarian cancer, PT regimen is superior to PC regimen in chemotherapy response rate, progression-free survival time and 3-year survival rate. The advantages of PT regimen in the advanced stage patients and the former are more significant.