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紫杉醇腹腔热灌注化疗在铂敏感复发性上皮性卵巢癌患者减瘤术后微小残留病灶中的作用。

The role of hyperthermic intraperitoneal chemotherapy using paclitaxel in platinum-sensitive recurrent epithelial ovarian cancer patients with microscopic residual disease after cytoreduction.

作者信息

Cascales-Campos Pedro Antonio, Gil J, Feliciangeli E, Gil E, González-Gil A, López V, Ruiz-Pardo J, Nieto A, Parrilla J J, Parrilla P

机构信息

Unidad De Cirugía De La Carcinomatosis Peritoneal, Departamento De Cirugía General, Virgen De La Arrixaca University Hospital, IMIB Arrixaca, Murcia, Spain,

出版信息

Ann Surg Oncol. 2015 Mar;22(3):987-93. doi: 10.1245/s10434-014-4049-z. Epub 2014 Sep 12.

Abstract

BACKGROUND

We analyzed the role of hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC) on the microscopic component of the disease in patients with a first recurrence of platinum-sensitive ovarian cancer after complete cytoreduction (CCR).

PATIENTS AND METHODS

We analyzed the data of 54 patients who were operated on between January 2001 and July 2012 with the diagnosis of platinum-sensitive recurrent ovarian cancer. In all patients, it was possible to achieve a CCR. Patients were divided into two groups: group I (cytoreduction alone) consisted of 22 surgical patients and group II (cytoreduction and HIPEC) consisted of 32 patients.

RESULTS

There were no significant differences in any of the preoperative variables studied. After a multivariate analysis of factors identified in the univariate analysis, only the presence of tumors with undifferentiated histology (hazard ratio 2.57; 95% CI 1.21-5.46; p < 0.05) was an independent factor associated with a reduced disease-free survival. The 1- and 3-year disease-free survival was 77 and 23% in patients from group I and 77 and 45% in patients from group II, respectively, with a tendency, but no significant differences (p = 0.078). There was no significant difference in postoperative morbidity between the two groups.

CONCLUSIONS

The administration of HIPEC in patients in whom it is possible to achieve a CCR of the disease has not increased postoperative morbidity and mortality rates in our center. HIPEC with paclitaxel is effective in the treatment of microscopic disease in platinum-sensitive recurrent epithelial ovarian cancer patients with microscopic residual disease after cytoreduction, although with no statistically significant difference.

摘要

背景

我们分析了术中腹腔内热灌注化疗(HIPEC)对铂敏感型卵巢癌初次复发患者在肿瘤细胞减灭术(CCR)后疾病微观成分的作用。

患者与方法

我们分析了2001年1月至2012年7月间接受手术治疗的54例铂敏感型复发性卵巢癌患者的数据。所有患者均有可能实现CCR。患者分为两组:I组(单纯肿瘤细胞减灭术)包括22例手术患者,II组(肿瘤细胞减灭术加HIPEC)包括32例患者。

结果

所研究的任何术前变量均无显著差异。在对单因素分析中确定的因素进行多因素分析后,只有未分化组织学类型肿瘤的存在(风险比2.57;95%置信区间1.21 - 5.46;p < 0.05)是与无病生存期缩短相关的独立因素。I组患者的1年和3年无病生存率分别为77%和23%,II组患者分别为77%和45%,有一定趋势但无显著差异(p = 0.078)。两组术后发病率无显著差异。

结论

在本中心,对有可能实现疾病CCR的患者进行HIPEC治疗并未增加术后发病率和死亡率。对于铂敏感型复发性上皮性卵巢癌且肿瘤细胞减灭术后有微小残留病灶的患者,紫杉醇HIPEC对微小病灶的治疗有效,尽管无统计学显著差异。

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