【作者】 江源；

【导师】 韩克；

【作者基本信息】 南京医科大学 ， 妇产科学， 2010， 硕士

【摘要】 【目的】:探讨术中运用缓释氟尿嘧啶治疗晚期卵巢癌的近期疗效和毒副反应。【方法】:对南京鼓楼医院2006年9月—2009年10月期间收治的62例晚期卵巢癌患者进行回顾分析,分为两组,术中植入5-Fu缓释剂+TP化疗组30例和TP化疗组32例。【结果】:两组术前的CA₁25水平比较,差异均无统计学意义（P>0.05）。5- Fu缓释剂+TP组平均CA₁25值降至22.5 U/ml,TP化疗组CA₁25值降至57.7 U/ml（P<0.05）,但第2次、第3次或第4次化疗后两组的CA₁25水平比较,差异无统计学意义（P>0.05）。初治卵巢癌患者的5-Fu缓释剂+TP组与TP组,第1次化疗后,5- Fu缓释剂+TP组平均CA₁25值降至15.6 U/ml,TP化疗组CA₁25值降至33.7 U/ml（P<0.05）,复发卵巢癌患者经第1次或第2次化疗后,5- Fu缓释剂+TP组平均CA₁25值分别降至24.5U/ml、21.4 U/ml,TP化疗组CA₁25值分别降至66.5U/ml、44.4 U/ml（P<0.05）。5-Fu缓释剂+TP组治疗后腹水有效率为68%,盆腔肿块有效率47%,淋巴结转移者有效率30%。两组在白细胞减少、贫血,血小板减少、胃肠道反应,肝功能损害、肾功能损害及脱发等方面比较,差异均无统计学意义（P>0.05）。5- Fu缓释剂+TP组中6例（20%）术后出现刺激性腹痛,但患者可以耐受。【结论】:在经过理想的肿瘤细胞减灭术的晚期卵巢癌患者中,术中运用5-Fu缓释剂腹腔化疗有效可行,特别是对复发性卵巢癌有较好的近期疗效,且不增加患者的毒副反应.临床上可以接受。更多还原

【Abstract】 【Objective】To evaluate the efficacy and side effects of sustained-release 5-Fluorouracil used during operation in the treatment of advanced ovarian elithelial carcinoma.【Methods】Retrospective analysis was utilized to analyze the clinical materials of 62 cases of advanced ovarian cancer in the Nanjing Drum Tower hospital from September 2006 to October 2009,Divided into two groups,30 cases in the group of sustained-release 5-Fluorouracil used during operation combined with TP chemotherapy after operation,and 32 cases in the group of TP chemotherapy after operation.【Result】Preoperative CA₁25 levels of the two groups, the difference was not statistically significan（tP>0.05）.After the first cycle chemotherapy,CA₁25 levels in sustained-release 5-Fluorouracil combined with TP chemotherapy group were lower than that in TP chemotherapy group（P<0.05）,but there were no significant difference between two groups after second,third or fourth cycle chemotherapy（P> 0.05）.For First treatment ovarian cancer patients,CA₁25 levels in sustained-release 5-Fluorouracil combined with chemotherapy group were lower than that in TP chemotherapy group after first cycle（P<0.05）,for the patients with recurrent ovarian cancer,CA₁25 levels in sustained-release 5-Fluorouracil combined with TP chemotherapy group were lower than that in TP chemotherapy group after first cycle（P<0.05）.After sustained-release 5-Fluorouracil combined with TP chemotherapy treatment, Ascites effective rate was 68%, Pelvic mass was 47% efficiency, Lymph node metastasis rate was 30%,but there were no significant differences between two groups in the toxicities of hypoleukemia, anemia, thrombocytopenia digestive disturbance,liver function damage,renal function damage,phalacrosis （P>0.05）But 6 cases had postoperative abdominal pain stimulation in sustained-release 5-Fluorouracil combined with TP chemotherapy group,but can be tolerated.【Conclusion】Intraoperative use of sustained-release 5-Fluorouracil intraperitoneal chemotherapy was effective and feasible for the advanced ovarian cancer after optimally cytoreductive surgery,In particular to recurrent ovarian cancer,and does not increase toxicity in patients ,so it can be clinically acceptable.更多还原