| 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 |
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| 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） |
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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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