A Comparative Study Of The Effiency Of Different Chemotherapy Regimens For Advanced Ovarian Cancer After R0 Operation

ObjectiveTo investigate the efficacy of different chemotherapy regimens after R0 operation for advanced ovarian cancer and the related factors affecting efficacy.MethodsThe clinical data of 217 patients with epithelial ovarian malignant tumors confirmed by pathology in Liaoning Cancer Hospital from January 2010 to December2014 were retrospectively analyzed,and no naked eye residual lesions(R0)were found after cytoreductive surgery.According to the chemotherapy regimen,the patients were divided into DC(docetaxel + carboplatin)regimen chemotherapy group and TC(paclitaxel + carboplatin)regimen chemotherapy group.Then,the short-term clinical efficacy,long-term clinical efficacy(progression-free survival(PFS)and overall survival(OS)),side effects during chemotherapy and related factors affecting the efficacy were compared between the two groups.T-test was used to analyze the difference of measurement data among groups.Chi-square test was used to analyze the difference of counting data,and Kaplan-Meier analysis,Log-rank test and Cox risk assessment model were used to analyze the single-factor and multi-factor survival.Results1.A total of 217 patients with advanced epithelial ovarian malignancies were enrolled.After cytoreductive surgery,90 patients underwent DC regimen chemotherapy and 127 patients underwent TC regimen chemotherapy.There was no significant difference in age,clinical stage,pathological type,differentiation degree,preoperative CA125 level,post-operative chemotherapy course and lymph node metastasis betweenDC and TC chemotherapy groups(P > 0.05).2.Comparison of short-term clinical efficacyThe effective cases of DC regimen chemotherapy group were 82,and the effective rate was 91%.Similarly,the effective cases of TC regimen chemotherapy group were114,the effective rate was 89.8%.The two groups had better treatment results after treatment,but there was no significant difference between the two groups(P=0.152).3.Comparison of long-term clinical efficacyThe time of PFS in DC regimen chemotherapy group was 3 months to 60 months,which median of time was 24 months.In terms of TC,the time of PFS in TC regimen chemotherapy group was 3 months to 62 months,which median of time was 22 months.There was a significant difference between the two groups(P=0.029).OS in DC regimen group was 4 months to 91 months,and median OS was 53 months.OS in TC regimen group was 5 months to 87 months,and median OS was 48 months.OS in DC regimen group was higher than that in TC regimen group,but there was no significant difference between the two groups(P=0.114).4.Comparison of side effects during chemotherapyNeurotoxicity occurred in 12 cases(13.3%)of the DC regimen chemotherapy group and 70 cases(55.1%)of the TC regimen chemotherapy group.The neurotoxicity of the DC regimen was significantly less than that of the TC regimen.There was a statistical difference between the two groups(P < 0.001).Leukocytopenia occurred in75 cases(83.3%)of DC regimen chemotherapy group and 99 cases(77.9%)of TC regimen chemotherapy group.According to the data,TC group was less than DC group,and there was significant difference between the two groups(P=0.025).In the DC regimen chemotherapy group,Hemoglobin decreased in 38 cases(42.2%),and thrombocytopenia decrease in 16 cases(17.8%).At the same time,liver dysfunction decreased in 47 cases(52.5%)and anaphylaxis decreased in 2 cases(2.2%).In TC chemotherapy group,63 cases(49.6%)had hemoglobin reduction,and 30 cases(23.6%)had thrombocytopenia.Meanwhile,47 cases(56.7%)had liver function damage,and 3cases(2.4%)had allergic reaction.There was no significant difference in hemoglobinreduction,thrombocytopenia,liver function damage and allergic reaction between the two groups(P > 0.05).5.Relevant factors affecting efficacyThe interval between postoperative chemotherapy is a relevant factor affecting efficacy.Age,FIGO stage,pathological type,degree of differentiation,neoadjuvant chemotherapy,preoperative CA125 level,postoperative chemotherapy course,or lymph node metastasis were not relevant factors influencing efficacy.Conclusion1.Advanced ovarian cancer R0 postoperative DC regimen chemotherapy progression-free survival is longer than TC regimen chemotherapy.2.The neurotoxicity of the DC regimen was significantly less than that of the TC regimen.The TC regimen had a leukopenia less than the DC regimen.3.Postoperative chemotherapy interval is a related factor affecting the efficacy of R0 after advanced ovarian cancer.