摘要
背景与目的:复发性卵巢癌的预后不良,对其处理仍未规范。本研究目的是探讨复发性卵巢癌治疗的意义和方法。方法:随机收集我院1990年2月至2000年12月收治的复发性卵巢癌54例。详细记录与肿瘤复发及治疗相关的临床数据,观察病例总的生存时间。对与生存有关的因素进行多因素分析,计算95％可信区间(95％ CI)。结果:多因素分析表明,肿瘤的无化疗缓解期>6个月,采用手术加化疗的治疗方法,可以明显延长患者的生存期(P<0.05)。与肿瘤的无化疗缓解期<6个月者相比,>6个月者的OR值为0.389。与采用手术加化疗方法比较,单一化疗的OR值为4.194。增加化疗的疗程数可能适当延长生存期(P=0.07)。与疗程数<6者比较,>10疗程的OR值为0.346。治疗开始的时间和化疗方案的选择对于生存期无明显影响(P<0.05)。结论:肿瘤的无化疗缓解期是复发性卵巢癌治疗的前提条件。对于肿瘤无化疗缓解期>6个月的病例,建议采取手术加化疗的治疗策略,以延长生存时间。对于铂类耐药者,治疗方法的选择以改善生活质量为目的。
BACKGROUND & OBJECTIVE: Recurrent ovarian cancer is associated with a poor prognosis, and optimal management for this problem is not well defined. The purpose of the study was to evaluate treatment opportunity for patients with recurrent ovarian cancer. METHODS: Fifty-four cases of recurrent ovarian cancer during 1990 to 2000 were randomly selected to compare the effect of treatment opportunity on the outcome. All the clinical data related to the recurrent ovarian cancer were collected. The difference in survival was calculated by the Cox model. RESULTS: The multivariate analysis showed that the platinum-free-interval > 6 months and the surgery followed salvage chemotherapy were associated with a significant prolongation of survival for the patients with recurrent ovarian cancer( P <0. 05). The odds ratio was 0. 389 for the patients whose platinum-free-interval was more than 6 months as compared to that of the platinum-free-interval <6 months. The OR was 4. 194 for the patients who were only with salvage chemotherapy as compared to that with surgery followed salvage chemotherapy. The numbers of chemotherapy cycles may offer some effect on the survival ( P = 0. 07) . The odds ratio (OR) was 0. 346 for the patients whose chemotherapy cycles were more than 10 as compared to that of chemotherapy cycles < 6. The timing of the beginning of the retreatment and chemotherapy regiments were failed to demonstrate an improvement in survival (P>0. 05). CONCLUSION: The treatment opportunity for patients with recurrent ovarian cancer is depend on the platinum-free-interval of the patients. A strategy of secondary surgical cytoreduction followed salvage chemotherapy is suggested for the patients whose platinum-free-interval > 6 months. The goal of the treatment for platinum-resistant patients is to improve the quality of life.
出处
《癌症》
SCIE
CAS
CSCD
北大核心
2003年第11期1188-1192,共5页
Chinese Journal of Cancer
