党彩玲;李力;覃金春;张洁清;阳志军;

• 1:广西医科大学附属肿瘤医院妇瘤科

摘要(Abstract)：

目的:分析影响铂类敏感型及耐药型复发上皮性卵巢癌(EOC)患者预后的相关临床病理因素。方法:回顾分析1985年1月至2011年11月广西医科大学附属肿瘤医院收治的复发EOC患者83例,其中铂类敏感型56例,耐药型27例。采用Kaplan-meier生存率曲线、Log-rank test检验和Cox模型多因素回归分析法分析影响复发EOC患者预后的相关因素。结果:(1)铂类敏感型复发EOC患者的中位无进展生存期(PFS)为11个月(95%CI 9.105～12.895),中位总生存期(OS)为16个月(95%CI 13.144～18.856);铂类耐药型复发EOC患者的中位PFS为8个月(95%CI 4.219～11.781),中位OS为10个月(95%CI 3.824～16.176)。(2)复发后伴有腹水、复发后化疗方案、化疗疗程、化疗效果是影响敏感型复发EOC患者的重要预后因素(P<0.05);无复发生存时间(RFS)、复发后伴有腹水、复发部位、化疗效果是影响耐药型复发EOC患者的重要预后因素(P<0.05)。(3)复发后化疗疗程数、复发后伴有腹水、化疗疗效是影响敏感型复发EOC患者预后的独立危险因素,而复发部位是影响耐药型复发EOC患者预后的独立危险因素。结论:铂类敏感型患者复发后宜选择与一线类似的铂类联合方案化疗,并尽可能化疗至6疗程。复发病灶位于盆腹腔是影响耐药型患者预后的独立危险因素,应积极治疗。

关键词(KeyWords)： 复发卵巢上皮癌;化疗;预后因素

Abstract:

Keywords:

基金项目(Foundation): 广西卫生厅科技项目(No:Z2010153)

作者(Authors): 党彩玲;李力;覃金春;张洁清;阳志军;

DOI: 10.13283/j.cnki.xdfckjz.2013.04.011

参考文献(References)：

• [1]Jemal A,Siegel R,Xu J,et al.Cancer statistics,2010[J].CA Cancer J Clin,2010,60(5):277-300
• [2]曹泽毅.妇科常见肿瘤诊治指南[M].第3版.北京:人民卫生出版社,2010:93-114
• [3]Choi CH,Lee YY,Song TJ,et al.Phase II study of belote-can,a camptothecin analogue,in combination with carbo-platin for the treatment of recurrent ovarian cancer[J].Cancer,2011,117(10):2104-2111
• [4]Hoekstra AV,Hurteau JA,Kirschner CV,et al.The combi-nation of monthly carboplatin and weekly paclitaxel ishighly active for the treatment of recurrent ovarian cancer[J].Gynecol Oncol,2009,115(3):377-381
• [5]Chan JK,Tian C,Teoh D,et al.Survival after recurrencein early-stage high-risk epithelial ovarian cancer:a Gyne-cologic Oncology Group study[J].Gynecol Oncol,2010,116(3):307-311
• [6]Zang RY,Harter P,Chi DS,et al.Predictors of survival inpatients with recurrent ovarian cancer undergoing seconda-ry cytoreductive surgery based on the pooled analysis of aninternational collaborative cohort[J].Br J Cancer,2011,105(7):890-896
• [7]Kataoka F,Tsuda H,Nomura H,et al.The chemosensitivi-ty of nodal metastases in recurrent epithelial ovarian canc-er[J].Eur J Gynaecol Oncol,2011,32(2):160-163
• [8]Milovic-Kovacevic M,Stamatovic L,Popov I,et al.Plati-num-sensitive relapsed epithelial ovarian cancer:not allthe patients benefit from reinduction with carboplatin andpaclitaxel[J].Med Sci Monit,2010,16(11):R549-R554
• [9]Rema PN,Suchetha S,Mathew AP,et al.Secondary cy-toreduction in epithelial ovarian cancer recurrence:a per-spective from a regional cancer center in India[J].J Re-prod Med,2009,54(8):506-510
• [10]Park JY,Eom JM,Kim DY,et al.Secondary cytoreduc-tive surgery in the management of platinum-sensitive re-current epithelial ovarian cancer[J].J Surg Oncol,2010,101(5):418-424
• [11]Gadducci A,Cosio S,Zola P,et al.The clinical outcomeof epithelial ovarian cancer patients with apparently isola-ted lymph node recurrence:a multicenter retrospective I-talian study[J].Gynecol Oncol,2010,116(3):358-363