| 许嵩,朱春芝,仝进毅.原发性腹膜癌的治疗结果和预后相关因素分析[J].浙江中西医结合杂志,2015,25(3): |
| 原发性腹膜癌的治疗结果和预后相关因素分析 |
| Analysis of treatment outcome and prognostic factors in patients with primary peritoneal carcinoma |
| 投稿时间：2014-03-18 修订日期：2015-01-18 |
| DOI： |
| 中文关键词: 原发性腹膜癌 治疗 预后 |
| 英文关键词:Primary peritoneal carcinoma Therapy Prognosis |
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| 中文摘要: |
| 目的 探讨原发性腹膜癌患者综合治疗的疗效及影响预后的相关因素。方法 回顾性分析27例原发性腹膜癌患者的临床特点,并结合随访资料进行预后因素分析。采用Kaplan-Meier法和Log rank法比较生存率,以Cox模型进行多因素回归分析。结果 全组患者的中位生存时间为40个月,3年生存率为63％。单因素分析结果显示,肿瘤的病理类型、手术后残余癌灶大小以及术后的化疗方案与患者的预后相关。Cox多因素回归分析的结果显示,肿瘤类型和化疗方案为独立预后因素。单纯浆液性肿瘤患者的中位生存时间分别为51个月,长于混合型肿瘤患者的37个月(P=0.023)。18例术后行TP方案化疗患者的生存时间明显长于行PAC方案化疗者,二者的中位生存时间分别为44和29个月(P=0.009)。结论 生存分析显示,原发性腹膜癌病理类型、手术效果和术后化疗方案与预后先关,其中化疗方案为影响其预后的的独立因素,建议在术中尽可能清除肉眼可见的病灶,化疗时以紫杉醇加铂类药物为基础,对此类患者应予以积极的多学科综合治疗,以进一步提高疗效。原发性腹膜癌的预后较差,有必要对其他的治疗方法(如新型药物、靶向治疗等)做进一步探索。 |
| 英文摘要: |
| Objective To evaluate the outcome of multimodal treatment for 27 patients with primary peritoneal carcinoma and discovery the prognostic factors. Methods This study included 27 patients with primary peritoneal carcinoma curatively treated in our hospital. Kaplan-Meier method was used to analyze the survival rate. Log rank test was used to evaluate the difference between the groups. Multivariate survival analysis was conducted using a Cox proportional hazard regression model with a backward stepwise procedure. Results The overall 3-year survival rate was 63％, respectively, with a median survival time of 40 months. The univariate analysis showed that the histological type of tumor, residual tumor size after the surgery and chemotherapy were correlated with prognosis. The multivariate analysis showed that the histological type of tumor and chemotherapy were independent prognostic factors. The different drug used in chemotherapy would significantly influence the survival. The median survival time of simple serous tumor and mixed tumor were 51 and 37 months, respectively (P=0.023). The median survival time of TP regimen and PAC regimen were 44 and 29 months, respectively (P=0.009). Conclusion The main prognostic factors are the effect of surgery and the regimen of chemotherapy. To remove as much as possible visible lesions during the surgery and the chemotherapy based on paclitaxel and platinum are recommended. The prognosis of patients with primary peritoneal carcinoma is poor, multiple treatments may improve the long-term survival of these patients. It is necessary to explore other treatment methods (such as new drugs, targeted therapy, etc.). |
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