CAJ | 학술논문

背景与目的：卵巢上皮癌确诊时约70%以上属晚期，目前ⅢC、Ⅳ期卵巢癌术后经一线标准化疗后，其5年无病生存率(disease free survival，DFS)约10%，本研究根据卵巢癌的特点，参考肿瘤细胞动力学和肿瘤药理学的原理，设计3步化疗法，以期提高ⅢC、Ⅳ期卵巢癌患者5年DFS。方法：研究组(A组， n=15)给予3步化疗法(紫杉醇+卡铂，每3周给药1次，共6~8个周期；依托泊甙+环磷酰胺，每4周给药1次，共6个周期；卡铂+环磷酰胺，每8周给药1次，共6个周期)治疗，对照组(B组，n=51)回顾分析2007年复旦大学附属肿瘤医院妇瘤科收治的ⅢC、Ⅳ期卵巢癌经标准一线化疗获临床缓解的患者(紫杉醇+卡铂，每3周给药1次，共6~8个周期)，比较2组5年DFS。结果：A组5年DFS为80%(12/15)，B组为5.9%(3/51)，差异有统计学意义(P<0.01)。结论：对ⅢC、Ⅳ期卵巢癌在满意细胞减灭术后，采用3步化疗法能提高5年DFS。该方案疗效好，不良反应轻，治疗费用低，值得进一步开展临床研究。
배경여목적：란소상피암학진시약70%이상속만기，목전ⅢC、Ⅳ기란소암술후경일선표준화료후，기5년무병생존솔(disease free survival，DFS)약10%，본연구근거란소암적특점，삼고종류세포동역학화종류약이학적원리，설계3보화요법，이기제고ⅢC、Ⅳ기란소암환자5년DFS。방법：연구조(A조， n=15)급여3보화요법(자삼순+잡박，매3주급약1차，공6~8개주기；의탁박대+배린선알，매4주급약1차，공6개주기；잡박+배린선알，매8주급약1차，공6개주기)치료，대조조(B조，n=51)회고분석2007년복단대학부속종류의원부류과수치적ⅢC、Ⅳ기란소암경표준일선화료획림상완해적환자(자삼순+잡박，매3주급약1차，공6~8개주기)，비교2조5년DFS。결과：A조5년DFS위80%(12/15)，B조위5.9%(3/51)，차이유통계학의의(P<0.01)。결론：대ⅢC、Ⅳ기란소암재만의세포감멸술후，채용3보화요법능제고5년DFS。해방안료효호，불량반응경，치료비용저，치득진일보개전림상연구。
Background and purpose:More than 70 percent of ovarian cancer patients were diagnosed in the advanced stage. Currently the 5-year disease free survival (DFS) of stageⅢC-Ⅳovarian cancer patients wsa about 10 percent after first line chemotherapy. This study aimed to improve the 5-year DFS by three-step chemotherapy according to the mechanisms of ovarian cancer biological characteristics, cytodynamics and pharmacology. Methods:In arm A, the patients received three-step chemotherapy after primary debulking surgery, step one with paclitaxel plus carboplatin (TC regimen), every 3 weeks for 6 to 8 cycles;step two with etoposide plus cyclophosphamide, every 4 weeks for 6 cycles;step three wit carboplatin plus cyclophosphamide every eight weeks for six cycles. In control arm B, we retrospectively analysed 51 cases withⅢC-Ⅳstage ovarian cancer, who had completely response after standard chemotherapy with six to eight cycles of TC after primary surgery during 2007. We compared the 5-year DFS between the two arms. Results:The 5-year DFS of 15 cases in arm A was 80%(12/15), which was signiifcantly higher than that of arm B (5.9%, 3/51, P<0.01). Conclusion: The three-step chemotherapy after optimal debulking surgery in stageⅢC-Ⅳ can improve the 5-year DFS. This regimen is high efficacy, mild side-effect witn low cost, which deserves further exploration.