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1、晚期卵巢癌術(shù)后順鉑與卡鉑腹腔化療的近期作用比較作者:張宇,楊越波,李田,李小毛單位:中山大學(xué)附屬第三醫(yī)院婦產(chǎn)科,廣東廣州510630【摘要】【目的】探討順鉑(DDP)與卡鉑(CBP)在卵巢癌腹腔化療中的作用?!痉椒ā繉ξ以?004年1月至2008年9月136例卵巢癌病例進(jìn)行回顧性分析,按入選標(biāo)準(zhǔn)入選37例,DDP組20例,CBP組17例?!窘Y(jié)果】DDP組與CBP組術(shù)前及術(shù)后第1次化療前的CA125水平比較,差異均無統(tǒng)計(jì)學(xué)意義(P>0.05)。第1次化療后,DDP組比CBP組CA125能降到更低水平(P<0.05
2、),但第2次、第3次或第4次化療后兩組的CA125水平比較,差異無統(tǒng)計(jì)學(xué)意義(P>0.05)。手術(shù)后有肉眼殘余病灶的病例經(jīng)第1次或第2次化療后,DDP組比CBP組CA125均能降到更低水平(P<0.05)。手術(shù)后無肉眼殘余病灶的,經(jīng)第1次、第2次或第3次化療后,DDP組與CBP組的CA125水平比較,差異無統(tǒng)計(jì)學(xué)意義(P>0.05)。兩組在白細(xì)胞減少、消化道反應(yīng)、肝功能損害、腎功能損害、脫發(fā)以及中止腹腔化療等方面比較,差異均無統(tǒng)計(jì)學(xué)意義(P>0.05),但在腹痛方面,I級腹痛的發(fā)生率DDP組(40%
3、,8/20)與CBP組(23%,4/17)比較,差異有統(tǒng)計(jì)學(xué)意義(P<0.05)?!窘Y(jié)論】在經(jīng)過理想的腫瘤細(xì)胞減滅術(shù)的晚期卵巢癌患者中,選用順鉑或卡鉑行腹腔化療都有效可行,但對仍有肉眼殘余病灶的病例,選用順鉑能在較短的療程內(nèi)起效?!娟P(guān)鍵詞】卵巢癌;腹腔化療;順鉑;卡鉑 RecentEfficacyandToxicityofCisplatinandCarboplatin inIntraperitonealChemotherapyforAdvancedOvarianCancer ZHANGYu,YANGYue-bo*
4、,LITian,LIXiao-mao (DepartmentofGynecologyandObstetrics,TheThirdAffiliatedHospital,SunYat-senUniversity,Guangzhou510630,China) Abstract:【Objective】Toevaluaterecentefficacyandtoxicityofcisplatin(DDP)andcarboplatin(CBP)intheintraperitonealchemotherapyforadvancedov
5、ariancancer.【Methods】Retrospectiveanalysiswasutilizedtoanalyzetheclinicalmaterialsof136casesofovariancancerintheThirdAffiliatedHospitalofSunYat-senUniversityfromJanuary2004toSeptember2008,and37casesmetthecriteria,primarystageIII,optimallycytoreducedovariancancerwi
6、thfulldetectionofCA125priortoeverycyclechemotherapy.AllcaseshadhighCA125levelbeforeoperationandatleast2cyclesofintraperitonealchemotherapy.BecauseofthelargerangeofCA125levels,rawCA125valueswerenaturallogtransformedandcomparedusingrepeatedmeasuresanalysisofvariance
7、(AVONA).【Result】TwentycasesmetinclusioncriteriaintheDDPgroupand17casesintheCBPgroup.TherewasnosignificantdifferenceofCA125betweentwogroupsbeforeoperationandfirstcyclechemotherapy(P>0.05).Afterthefirstcyclechemotherapy,CA125levelsinDDPgroupwerelowerthanthatinCBP
8、group(P<0.05),buttherewerenosignificantdifferencebetweentwogroupsaftersecond,thirdorfourthcyclechemotherapy(P>0.05).Forthepatientswithgrossresidua