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[目的]探讨术前新辅助化疗在晚期卵巢癌治疗中的应用价值。[方法]1987～1998年初次治疗的Ⅲ期、Ⅳ期卵巢癌患者303例,Ⅲ期251例,Ⅳ期52例。145例直接手术减瘤(直接手术组),其中Ⅲ期136例,Ⅳ期9例;158例术前行新辅助化疗(新辅助化疗组),其中Ⅲ期115例,Ⅳ期43例。[结果]无残存肿瘤、残存肿瘤≤2cm、2.1～5cm、>5cm中位生存时间,Ⅲ期分别为54、33、24、16个月,Ⅳ期为42、30、17、16个月(P<0.05)。5年生存率:Ⅲa期、Ⅲb期为36.7%,Ⅲc期20.8%,Ⅳ期为22.4%。有、无新辅助化疗总的中位生存时间21.3个月比27.0个月,两组之间无统计学差异(P=0.062)。术后化疗疗程数<6个疗程与≥6个疗程相比中位生存时间17个月与39个月(P<0.001)。术前新辅助化疗疗程数对生存率无影响,增加疗程数并不能提高生存率。[结论]术前新辅助化疗手术满意减瘤率高,总的生存期与常规手术组无差异。
[Objective] To investigate the value of preoperative neoadjuvant chemotherapy in the treatment of advanced ovarian cancer. [Method] A total of 303 patients with stage Ⅲ and stage Ⅳ ovarian cancer, 251 patients with stage Ⅲ and 52 patients with stage Ⅳ were treated for the first time from 1987 to 1998. One hundred and forty-five patients underwent direct surgery for tumor reduction (direct surgery group), including 136 in stage Ⅲ and 9 in stage Ⅳ; and 158 in neoadjuvant chemotherapy (neoadjuvant chemotherapy) group, including 115 in stage Ⅲ and 43 in stage Ⅳ. [Results] The median survival time of residual tumor less than or equal to 2cm, 2.1 ~ 5cm and> 5cm were 54, 33, 24 and 16 months respectively, P <0.05). 5-year survival rate: Ⅲ a period, Ⅲ b 36.7%, Ⅲ c 20.8%, Ⅳ period of 22.4%. There was no statistically significant difference (P = 0.062) between the two groups with a median overall survival of 21.3 months compared with 27.0 months without neoadjuvant chemotherapy. The median duration of postoperative chemotherapy courses <6 courses versus> 6 courses was 17 months and 39 months (P <0.001). The number of neoadjuvant chemotherapy preoperatively had no effect on the survival rate. Increasing the number of treatments did not improve the survival rate. [Conclusion] The satisfactory rate of tumor reduction by neoadjuvant chemotherapy before operation is no different from the conventional surgery group.