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目的探讨先期化疗在治疗晚期卵巢癌中的临床意义和对预后的影响。方法分析我院52例Ⅲ、Ⅳ期卵巢癌患者,22例行先期化疗,然后进行中间肿瘤细胞减灭术及术后化疗(先期化疗组);30例行初次肿瘤细胞减灭术,再行术后化疗(对照组)。比较两组治疗的疗效及生存率。结果先期化疗组化疗有效率63.6%,胸腹水的控制率达89.5%,先期化疗组和对照组满意肿瘤减灭率分别为81.8%、36.7%,两组比较差异有统计学意义(P<0.005);先期化疗组术中出血量及手术时间较对照组少,两组比较差异均有统计学意义(P<0.05);先期化疗组术后并发症发生率13.6%,对照组术后并发症发生率20.0%,两组比较差异无统计学意义(P>0.05)。先期化疗组和对照组中位生存时间分别为35和24个月,两组间生存率比较,差异无统计学意义(P>0.05)。结论先期化疗能缩小瘤体,控制胸腹水,提高肿瘤细胞减灭率,特别对大量胸腹水、肿瘤体积较大和身体耐受差的患者疗效佳,但并未延长患者总的生存时间。
Objective To investigate the clinical significance and prognosis of advanced chemotherapy in the treatment of advanced ovarian cancer. Methods Fifty-two patients with stage Ⅲ and Ⅳ ovarian cancer in our hospital were analyzed. Twenty-two patients received advanced chemotherapy and then received cytoreductive surgery and postoperative chemotherapy (initial chemotherapy). Thirty patients underwent primary cytoreductive surgery, Postoperative chemotherapy (control group). The curative effect and survival rate of the two groups were compared. Results The effective rate of chemotherapy in advanced chemotherapy group was 63.6%, and the control rate of pleural effusion and ascites fluid was 89.5%. The satisfactory rate of tumor elimination in advanced chemotherapy group and control group was 81.8% and 36.7% respectively, with significant difference between the two groups (P <0.005 ). The bleeding volume and operation time in the early chemotherapy group were less than those in the control group, with significant difference between the two groups (P <0.05). The incidence of postoperative complications in the advanced chemotherapy group was 13.6% The incidence was 20.0%, there was no significant difference between the two groups (P> 0.05). The median survival time in the advanced chemotherapy and control groups was 35 and 24 months, respectively. There was no significant difference in survival rates between the two groups (P> 0.05). Conclusions Advanced chemotherapy can reduce the size of the tumor, control the hydrothorax and ascites fluid, and improve the cytocidal rate of tumor cells. Especially for pleural effusion and ascites, the patients with large tumor volume and poor body tolerance have good curative effect, but not prolong the overall survival time of patients.