新辅助化疗联合腹腔镜下中间型肿瘤细胞减灭术治疗ⅢC期卵巢上皮性癌的临床研究

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目的探讨新辅助化疗联合腹腔镜下中间型肿瘤细胞减灭术治疗卵巢上皮性癌ⅢC期的临床疗效。方法以入院病例号为编号,根据随机数字表,将浙江天台中医院120例卵巢上皮性癌ⅢC期患者(于2010年10月—2013年4月入科治疗)随机分成2组,每组60例。观察组给予新辅助化疗(紫杉醇135~175 mg/m~2+顺铂75~100 mg·m~2)联合中间性肿瘤细胞减灭术;对照组首先行肿瘤细胞减灭术,再予化疗。2组术后均予紫杉醇+卡铂+顺铂化疗。比较2种方案的近期疗效、肿瘤细胞减灭术实施情况、患者生存率。结果观察组术中失血量[(523.6±58.6)ml]、手术时间[(223.6±31.6)min]及腹水量[(665.5±65.6)ml],均低于对照组,P<0.05;2组术后住院时间比较差异无统计学意义(P>0.05)。观察组治疗后近期总有效率为78.3%,优于对照组的56.6%,差异具有统计学意义(P<0.05)。观察组3年生存率显著高于对照组,差异具有统计学意义(P<0.05)。结论新辅助化疗联合腹腔镜下中间型肿瘤细胞减灭术可提高ⅢC期卵巢上皮性癌手术质量,降低术后并发症,提高患者生活质量。 Objective To investigate the clinical efficacy of neoadjuvant chemotherapy combined with laparoscopic median cytoreductive surgery in the treatment of stage Ⅲ C ovarian epithelial cancer. Methods Based on the random number table, 120 patients with stage ⅢC ovarian epithelial cancer (from October 2010 to April 2013 in Zhejiang Tiantai Hospital of Traditional Chinese Medicine) were randomly divided into two groups (60 in each group) example. Neoadjuvant chemotherapy (paclitaxel 135 ~ 175 mg / m ~ 2 + cisplatin 75 ~ 100 mg · m ~ 2) was given to the observation group. The control group was treated with cytoreductive surgery and chemotherapy . Two groups were given paclitaxel + carboplatin + cisplatin after chemotherapy. Compare the short-term efficacy of two kinds of programs, the implementation of tumor cytoreductive surgery, patient survival rate. Results The blood loss in the observation group was (523.6 ± 58.6) ml, the operation time was (223.6 ± 31.6) min and the amount of ascites was (665.5 ± 65.6) ml, both lower than those in the control group There was no significant difference in postoperative hospital stay (P> 0.05). The total effective rate of the observation group after treatment was 78.3%, which was better than 56.6% of the control group, the difference was statistically significant (P <0.05). The 3-year survival rate of the observation group was significantly higher than that of the control group, the difference was statistically significant (P <0.05). Conclusions Neoadjuvant chemotherapy combined with laparoscopic median cytoreductive surgery can improve the surgical quality of stage Ⅲ C epithelial ovarian cancer, reduce the postoperative complications and improve the quality of life of patients.
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