Sun X, Li X, Li H
Cancer Hospital, Chinese Academy of Medical Science, Beijing.
Zhonghua Zhong Liu Za Zhi. 1995 Jan;17(1):39-42.
The records of 532 patients with advanced ovarian cancer during March 1977 to February 1993 were retrospectively reviewed. Fifty-seven cases developed intestinal obstruction, and 54 cases died of this complication. The median survival period for all patients with obstruction was 110 days, and only 5 cases survived for more than one year. Twenty-three cases were treated mainly by surgery, 18 by chemotherapy, and 16 by conservative measures. The median survival periods for each group was 96 days, 120 days, and 81 days, respectively. Their survival times are not statistically different (P > 0.05). Of the patients surgically treated, 61% (14/23) benefited from operation, 26% (6/23) had inoperable disease at laparotomy, and 9% (2/23) developed fatal surgical complications. Even though the response rate in patients receiving chemotherapy was much higher than in those surgically treated (P < 0.05), the effect of chemotherapy was just temporary, and occurred only in patients who had never been treated with high dose PDD-based regimens. In this report, the individualized management of intestinal obstruction induced by ovarian cancers is suggested, and indications and contraindications for three treatment modalities are proposed.
回顾性分析了1977年3月至1993年2月期间532例晚期卵巢癌患者的病历。57例发生肠梗阻,54例死于该并发症。所有肠梗阻患者的中位生存期为110天,仅5例存活超过1年。23例主要接受手术治疗,18例接受化疗,16例采取保守治疗。每组的中位生存期分别为96天、120天和81天。它们的生存时间无统计学差异(P>0.05)。接受手术治疗的患者中,61%(14/23)从手术中获益,26%(6/23)在剖腹手术时发现疾病无法切除,9%(2/23)发生致命的手术并发症。尽管接受化疗患者的缓解率远高于接受手术治疗的患者(P<0.05),但化疗效果只是暂时的,且仅发生在从未接受过基于顺铂高剂量方案治疗的患者中。本报告建议对卵巢癌引起的肠梗阻进行个体化管理,并提出了三种治疗方式的适应证和禁忌证。