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目的 对晚期卵巢上皮性癌的综合治疗进行研究 ,并对其预后因素加以分析。方法选择复旦大学附属肿瘤医院 1 998年 1月至 2 0 0 0年 1 2月收治的晚期卵巢上皮性癌患者 53例 (研究组 ) ,给予综合治疗即诱导缓解、巩固治疗和免疫支持治疗。另选择 1 986年 1月至 1 997年 1 2月间收治的晚期卵巢上皮性癌患者 31 8例 (对照组 ) ,给予肿瘤细胞减灭术及常规化学药物治疗 (化疗 )。结果 研究组的完全缓解率、部分缓解率分别为 90 6 %、5 7% ,均明显高于对照组的 70 1 %、5 3 % (P<0 0 1 ) ;研究组的 1、2、3年生存率分别为 97 7%、89 1 %、83 6 % ,均明显高于对照组的 71 8%、44 1 %、2 9 8% (P <0 0 1 ) ;研究组的 1、2、3年无癌生存率分别为 92 6 %、75 0 %、75 0 % ,均明显高于对照组的 60 3 %、37 8%、2 8 6 % (P <0 0 1 ) ;研究组 1、2年的肿瘤复发率分别为 7 5 %、2 5 0 % ,均明显低于对照组的 39 7%、62 2 % (P <0 0 1 )。和预后有关的因素有年龄、首治医院、手术病理分期、腹水、病理分化程度、术前化疗、术后腹腔化疗和静脉化疗。和无癌生存相关的预后因素是首治医院、卵巢侵犯程度、残留癌直径大小和术后腹腔化疗。结论 通过诱导缓解、巩固治疗和免疫支持治疗可提高疗效 ,明显降低了晚期?
Objective To study the comprehensive treatment of advanced epithelial ovarian cancer and to analyze its prognostic factors. Methods Fifty-three patients (study group) with advanced epithelial ovarian cancer who were admitted to Cancer Hospital Affiliated to Fudan University from January 1998 to January 2010 were treated with induction therapy, induction therapy, consolidation therapy and immune supportive therapy. Another 318 patients with advanced epithelial ovarian cancer (control group) who were admitted between January 986 and January 1997 were enrolled in this study. They were given cytoreductive surgery and conventional chemotherapy (chemotherapy). Results The complete remission rate and partial remission rate were 90.6% and 57% in the study group, which were significantly higher than those in the control group (70.1% and 53%, respectively) (P <0.01) The 3-year survival rates were 97.7%, 89.1% and 83.6%, respectively, which were significantly higher than 71.8%, 44.1% and 298% of the control group (P <0.01) The cancer-free survival rates at 2 and 3 years were 92.6%, 75.0% and 75.0%, respectively, which were significantly higher than those in the control group (60.3%, 37.8% and 28.6%, P <0.01) The tumor recurrence rates in 1 and 2 years were 75% and 25% respectively, which were significantly lower than those in control group (39.7% and 62.2%, P <0.01). And prognosis related factors are age, the first hospital, surgical pathology, ascites, pathological differentiation, preoperative chemotherapy, postoperative intraperitoneal chemotherapy and intravenous chemotherapy. The prognostic factors associated with cancer-free survival were the first hospital, the extent of ovarian invasion, residual cancer size, and postoperative intraperitoneal chemotherapy. Conclusion Through induction of remission, consolidation therapy and immune support therapy can improve the curative effect, significantly reduce the late?