孙建华,姬忠贺,李 雁.细胞减灭术加腹腔热灌注化疗治疗复发性卵巢癌[J].肿瘤学杂志,2018,24(3):240-246.
细胞减灭术加腹腔热灌注化疗治疗复发性卵巢癌
Survival Benefit of Cytoreductive Surgery plus Hyperthermic Intraperitoneal Chemotherapy for Recurrent Epithelial Ovarian Cancer
投稿时间:2017-02-18  
DOI:10.11735/j.issn.1671-170X.2018.03.B013
中文关键词:  复发性卵巢癌  细胞减灭术  腹腔热灌注化疗  总生存
英文关键词:recurrent epithelial ovarian cancer  cytoreductive surgery  hyperthermic intraperitoneal chemotherapy  overall survival
基金项目:首都特色应用研究与成果推广项目(Z161100000516077);北京市自然科学基金项目(7172108);首都医科大学附属北京世纪坛医院重点学科建设项目(2016fmzlwk),恩施州科技计划研究与开发项目(D2014007)
作者单位
孙建华 首都医科大学附属北京世纪坛医院 
姬忠贺 首都医科大学附属北京世纪坛医院 
李 雁 首都医科大学附属北京世纪坛医院 
摘要点击次数: 1996
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中文摘要:
      摘 要:[目的] 研究细胞减灭术(CRS)加术中腹腔热灌注化疗(HIPEC)治疗复发性卵巢癌的疗效及安全性。[方法] 回顾性分析59例复发性上皮性卵巢癌患者的临床病理资料,研究组(CRS+HIPEC+术后辅助化疗)28例和对照组(CRS+术后辅助化疗)31例。主要终点指标为总生存期(OS),次要指标为安全性。[结果] 两组患者的临床病理特征均匹配,中位OS分别为30.0月(95%CI:25.3~34.8)和22.8月(95%CI:18.2~27.4)(P=0.029)。1年、3年、5年生存率分别为85.7%、46.4%、39.3%和71.0%、35.5%、25.8%。CRS+HIPEC组中,铂类敏感型和耐药型患者的中位OS分别为30.0月(95%CI:6.5~57.1)和31.8月(95%CI:25.5~34.5)(P =0.633)。两组患者均无围手术期死亡病例,严重不良事件的发生率分别为17.9%和9.7%。多因素分析显示CRS+HIPEC,CC0-1、术后化疗≥6个周期为改善生存的独立预后因素。[结论] CRS+HIPEC可延长复发性卵巢癌患者的生存期,严重不良事件无明显增加,安全可行。
英文摘要:
      Abstract:[Objective] To evaluate the efficacy and safety of cytoreductive surgery(CRS) plus hyperthermic intraperitoneal chemotherapy(HIPEC) in treatment of recurrent epithelial ovarian cancer(ROC). [Methods] Fifty nine consecutive patients with recurrent EOC were enrolled in the study,including 28 patients treated with CRS+HIPEC(study group),and 31 patients treated with CRS alone(control group). The primary endpoint was overall survival(OS) from the first recurrence after initial treatment with debulking surgery and systemic chemotherapy to disease-related death. The secondary endpoints were safety profiles. [Results] The clinicopathologic characteristics of patients were well balanced and comparable between the two groups. The median OS was 30.0 months(95%CI:25.3~34.8) for study group and 22.8 months(95%CI:18.2~27.4) for control group(P=0.029). The 1-,3-,and 5- year survival rates of study group and control group were 85.7% versus 71.0%,46.4% versus 35.5%,and 39.3% versus 25.8%,respectively. In study group,the median OS was 30.0 months(95%CI:6.5~57.1) for platinum-sensitive patients vs. 31.8 months(95%CI:25.5-34.5) for platinum resistant patients(P=0.633). There was no perioperative death. Postoperative serious adverse events was 17.9% and 9.7% for study and control groups,respectively,. Multivariate analysis revealed that CRS+HIPEC,CC(completeness of cytoreduction) 0-1,and postoperative chemotherapy ≥ 6 cycles were the independent factors for OS improvement. [Conclusion] The CRS+HIPEC protocol improves the OS of recurrent EOC patients,with acceptable safety profiles.
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