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紫杉醇腹腔热灌注化疗巩固治疗上皮性卵巢癌。

Consolidation hyperthermic intraperitoneal chemotherapy using paclitaxel in patients with epithelial ovarian cancer.

机构信息

Department of Obstetrics and Gynecology, Seoul Saint Mary's Hospital, The Catholic University of Korea, Seoul 137-040, South Korea.

出版信息

J Surg Oncol. 2010 Feb 1;101(2):149-55. doi: 10.1002/jso.21448.

Abstract

BACKGROUND

We evaluated the efficacy and feasibility of hyperthermic intraperitoneal chemotherapy (HIPEC) using paclitaxel as consolidation therapy in patients with epithelial ovarian cancer.

METHODS

Between November 1999 and January 2004, 18 patients with a negative second-look and 1 patient with positive peritoneal cytology only with stage Ic-IIIc epithelial ovarian cancer received consolidation intra-operative HIPEC using paclitaxel. The HIPEC was performed with open-abdomen technique, using 6 L of lactated Ringer's solution containing paclitaxel 175 mg/m(2), for 90 min in hyperthermic phase (43-44 degrees C). The survival rates were compared with 24 patients treated with conventional therapy (control group).

RESULTS

The 8-year progression-free survival rates were 63.16% in the HIPEC-paclitaxel group and 29.17% in the control group (P = 0.027). The 8-year overall survival rates were 84.21% in the HIPEC-paclitaxel group and 25.00% in the control group (P = 0.0004). The time interval between initial treatment and HIPEC was statistically significant with respect to progression-free and overall survival in the HIPEC-paclitaxel group.

CONCLUSION

HIPEC with paclitaxel during 2nd-look laparotomy is feasible and relatively safe and showed a good effect on survival. In patients with epithelial ovarian cancer who have a complete pathologic response, HIPEC with paclitaxel should be considered as a consolidation treatment option.

摘要

背景

我们评估了紫杉醇作为巩固治疗在接受上皮性卵巢癌二次探查术患者中应用腹腔内热灌注化疗(HIPEC)的疗效和可行性。

方法

1999 年 11 月至 2004 年 1 月,18 例二次探查阴性和 1 例仅腹腔细胞学阳性的 Ic-IIIc 期上皮性卵巢癌患者接受术中紫杉醇巩固性 HIPEC。采用开腹技术,使用含紫杉醇 175mg/m2 的乳酸林格氏液 6L,在高温期(43-44℃)进行 90 分钟 HIPEC。将生存率与接受常规治疗的 24 例患者(对照组)进行比较。

结果

HIPEC-紫杉醇组 8 年无进展生存率为 63.16%,对照组为 29.17%(P=0.027)。HIPEC-紫杉醇组 8 年总生存率为 84.21%,对照组为 25.00%(P=0.0004)。HIPEC-紫杉醇组中初始治疗与 HIPEC 之间的时间间隔与无进展生存和总生存均有统计学意义。

结论

在二次探查术中应用紫杉醇 HIPEC 是可行的,相对安全,对生存有较好的效果。对于完全病理缓解的上皮性卵巢癌患者,应考虑将紫杉醇 HIPEC 作为巩固治疗选择。

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