作　　者： (龙行涛）; (周琦）; (王海霞）; (王冬）; (邹冬玲）;

机构地区： 重庆市肿瘤医院,重庆市肿瘤研究所,重庆市癌症中心,妇科肿瘤科,重庆400030

出　　处： 《中国癌症杂志》 2017年第8期661-667,共7页

摘　　要： 背景与目的:目前老年卵巢癌特别是晚期卵巢癌的治疗趋于保守,往往不能得到标准治疗,这方面的治疗经验及研究比较少。该研究旨在探讨老年晚期上皮性卵巢癌患者治疗结局、生存及影响预后相关因素。方法:回顾性分析重庆市肿瘤医院2008年4月—2012年12月收治的年龄大于等于65岁,Ⅲ、Ⅳ期上皮性卵巢癌患者临床资料,随访生存状况,分析影响预后的因素。结果:181例患者符合纳入标准,8.8%的患者未治疗,12.7%的患者接受单纯手术,15.5%的患者接受单纯化疗,33.2%的患者接受非标准治疗,29.8%的患者接受标准治疗。不同治疗方法基线比较,标准治疗组患者合并心脑血管疾病比例较低(P=0.001)。校正心脑血管合并症后,标准治疗组中位生存时间(48个月)、非标准治疗组中位生存时间(47个月)均明显长于其他组(P<0.001);单纯化疗组中位生存时间(26个月)明显长于单纯手术及未治疗组(P<0.001),而单纯手术组中位生存时间与未治疗组相似(9个月vs 8个月,P=0.269)。COX比例风险回归分析治疗方法、残余病灶大小、心脑血管合并症为影响卵巢癌预后的独立因素。结论:标准治疗仍是影响老年晚期上皮性卵巢癌患者预后的最重要因素。若患者不能耐受手术及术后辅助化疗,单纯化疗预后明显优于单纯手术,而单纯手术并不改善预后。 Background and purpose： At present, the treatment of elderly patients with ovarian cancer, espe-cially advanced ovarian cancer, tends to be conservative, and elderly patients often can not receive standard treatment. There are few treatment experiences and research data. This study aimed to investigate the treatment outcome, survival and prognostic factors of elderly patients with advanced epithelial ovarian cancer. Methods： This study retrospectively analyzed the clinical data for women older than 65 years diagnosed with stage Ⅲ and Ⅳ epithelial ovarian cancer between Apr. 2008 to Dec. 2012 in Chongqing Cancer Hospital. Results： Of the 181 women who met study criteria, 8.8% received no treatment, 12.7% underwent surgery alone, 15.5% received chemotherapy alone, 33.2% underwent non-standard treatment, 29.8% underwent standard treatment. Baseline comparison of different treatment methods showed that the proportion of patients with cardiovascular and cerebrovascular diseases was lower in the standard treatment group. After Correcting the effect of cardio-cerebrovascular diseases, the median survival time of standard treatment （48 months） and the median survival time of non-standard treatment （47 months） were significantly longer than that of the other treatment groups （P〈0.001）. The median survival time of chemotherapy alone （26 months） was significantly longer than that of the surgery alone and untreated group （P〈0.001）, while the median survival time of surgery alone was similar to untreated group （9 months vs 8 months, P=0.269）. Multivariate analysis using Cox model showed that treatment, residual lesion size, cardio-cerebrovascular diseases significantly impacted on survival time. Conclusion： Standard treatment was still the key factor for the best survival of elderly women with advanced ovarian cancer. When this is not offered or possible, chemother-apy alone offers better survival than surgery alone. However, surgery alone does not improve prognosis.

关 键 词： 老年 卵巢肿瘤 预后 化学疗法