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顺铂联合多柔比星或紫杉醇在腹腔热灌注化疗(HIPEC)治疗 IIIC 期或 IV 期上皮性卵巢癌中的应用:一项对比研究。

The use of cisplatin plus doxorubicin or paclitaxel in hyperthermic intraperitoneal chemotherapy (HIPEC) for stage IIIC or IV epithelial ovarian cancer: a comparative study.

机构信息

Peritoneal Carcinomatosis Unit, Department of General and Digestive Surgery, University Hospital of Fuenlabrada, C/ Camino del Molino 2, 28942, Fuenlabrada, Madrid, Spain.

Rey Juan Carlos University (URJC), Madrid, Spain.

出版信息

Clin Transl Oncol. 2019 Oct;21(10):1357-1363. doi: 10.1007/s12094-019-02065-3. Epub 2019 Feb 20.

Abstract

PURPOSE

Our main aim is to analyze the survival results in women operated on for advanced ovarian cancer with two different HIPEC regimens (cisplatin plus doxorubicin versus paclitaxel).

PATIENTS AND METHODS

A prospective cohort of patients with stage IIIC or IV epithelial ovarian cancer operated on with cytoreductive surgery and HIPEC, from October-2008 to February-2016, was retrospectively analyzed. The two drugs used, cisplatin/doxorubicin (Group A) and paclitaxel (Group B), were compared.

RESULTS

Forty-one patients were treated with cytoreductive surgery and HIPEC; 19 patients (46%) were in Group A and 22 (54%) were in Group B. The extent of peritoneal disease was comparable between groups (Peritoneal Cancer Index of 10 in Group A versus PCI of 12.5 in Group B). There were no differences in morbidity between groups, with a severe morbidity (Dindo-Clavien III or IV) of 36.8% versus 27.3%, respectively. There was no postoperative mortality. Median follow-up was 39 months. Median overall survival was 79 months. Overall survival at 3 years in Group A was 66% versus 82.9% in Group B (p = 0.248). Incomplete cytoreduction (macroscopic residual tumour after surgery) was identified as the only independent factor that influenced overall survival (HR 12.30, 95% CI 1.28-118.33, p = 0.03). The cytostatic used in HIPEC had no influence in overall survival.

CONCLUSION

The cytostatic used in HIPEC did not have a negative effect in the prognosis of patients with advanced ovarian cancer.

摘要

目的

我们的主要目的是分析两种不同 HIPEC 方案(顺铂加多柔比星与紫杉醇)治疗晚期卵巢癌患者的生存结果。

患者和方法

回顾性分析了 2008 年 10 月至 2016 年 2 月接受细胞减灭术和 HIPEC 治疗的 IIIC 或 IV 期上皮性卵巢癌患者的前瞻性队列。比较了两种药物,顺铂/多柔比星(A 组)和紫杉醇(B 组)。

结果

41 例患者接受细胞减灭术和 HIPEC 治疗;19 例(46%)患者为 A 组,22 例(54%)患者为 B 组。两组患者腹膜疾病程度相当(A 组腹膜癌指数为 10,B 组为 12.5)。两组之间的发病率无差异,严重发病率(Dindo-Clavien III 或 IV)分别为 36.8%和 27.3%。无术后死亡。中位随访时间为 39 个月。中位总生存期为 79 个月。A 组 3 年总生存率为 66%,B 组为 82.9%(p=0.248)。不完全肿瘤细胞减灭术(手术后肉眼残留肿瘤)是影响总生存期的唯一独立因素(HR 12.30,95%CI 1.28-118.33,p=0.03)。HIPEC 中使用的细胞抑制剂对总生存期没有影响。

结论

HIPEC 中使用的细胞抑制剂对晚期卵巢癌患者的预后没有不良影响。

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