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目的探讨新辅助化疗联合间隔减瘤术(neoadjuvant chemotherapy followed by interval debulking surgery,NACT/IDS)在晚期卵巢癌中的临床应用价值。方法回顾性分析上海交通大学附属瑞金医院2000年6月至2013年1月109例IIIc和IV期晚期卵巢癌患者资料,将53例直接行肿瘤减灭术(primary debulking surgery,PDS)患者纳入PDS组,将56例行NACT/IDS患者纳入NACT/IDS组,比较两组的生存率及围手术期情况。结果两组患者术后总生存率(overall survival,OS)和无病进展期(progression-free survival,PFS)比较差异均无统计学意义(P>0.05)。NACT/IDS组手术切除率(53.6%)明显高于PDS组(43.4%)(P<0.05);NACT/IDS组手术出血量、术后恢复、并发症的发生情况优于PDS组(P<0.05)。结论 NACT/IDS增加了手术切除率,减少了手术创伤,术后生存率与PDS无明显差异。在Ⅲc期和Ⅳ期卵巢癌患者,并非强调直接行PDS,NACT/IDS是有效的治疗方法。
Objective To investigate the clinical value of neoadjuvant chemotherapy followed by interval debulking surgery (NACT / IDS) in advanced ovarian cancer. Methods The data of 109 patients with advanced stage IIIc and IV ovarian cancer from June 2000 to January 2013 in Ruijin Hospital Affiliated to Shanghai Jiao Tong University were retrospectively analyzed. 53 patients with primary debulking surgery (PDS) were enrolled in PDS Group, 56 patients with NACT / IDS were included in the NACT / IDS group, and the survival rate and perioperative period were compared between the two groups. Results There was no significant difference in overall survival (OS) and progression-free survival (PFS) between the two groups (P> 0.05). The surgical resection rate in NACT / IDS group (53.6%) was significantly higher than that in PDS group (43.4%) (P <0.05). The surgical bleeding volume, postoperative recovery and complications in NACT / IDS group were better than those in PDS group (P < 0.05). Conclusion NACT / IDS increases the resection rate and reduces the surgical trauma. The postoperative survival rate has no significant difference with PDS. In stage Ⅲc and Ⅳ ovarian cancer patients, not directly emphasizing PDS, NACT / IDS is an effective treatment.