| Background and ObjectiveOvarian cancer is the most lethal malignant tumor in the female reproductive system,and the first-line treatment for ovarian cancer is cytoreductive surgery and combined chemotherapy based on platinum after surgery.Ovarian epithelial cancer,is prone to peritoneal implantation and metastasis.Metastases often lack new blood vessels,so the curative effect of chemotherapy is not good.Through pharmacokinetic analysis,Compared with intravenous chemotherapy,intraperitoneal chemotherapy has obvious advantages:chemotherapeutic drugs could directly contact with lesions;the pharmacokinetic advantage is significant;the drug exposure of lesions is prolonged;chemotherapy drugs in the abdominal cavity are mostly absorbed through the portal vein and the toxicity of the drugs is significantly reduced after metabolism by the liver.Therefore,the value of intraperitoneal chemotherapy for the treatment of ovarian cancer has been gradually valued.At present,cisplatin is mostly used in intraperitoneal chemotherapy,but its severe toxic reactions make some patients intolerable.Carboplatin is significantly less toxic than cisplatin,and has good tissue penetration,and it can be absorbed through the peritoneum,therefore,in theory,carboplatin has certain advantages in intraperitoneal chemotherapy.Some scholars have proposed the use of carboplatin instead of cisplatin for intraperitoneal chemotherapy,which has been used clinically,but there are few reports on its efficacy at home and abroad.This paper uses a prospective study to randomly divide 126 patients with ovarian epithelial cancer who have undergone satisfactory cytoreductive surgery into three groups,and respectively receive carboplatin intravenous chemotherapy,carboplatin intraperitoneal chemotherapy and cisplatin intraperitoneal chemotherapy.To compare the efficacy,toxicity,the effects on quality of life,recurrence,and survival time of the three chemotherapy regimens,and explore the safety and effectiveness of carboplatin intraperitoneal chemotherapy.Materials and Methods1.Specimen source:126 patients with stage ??? epithelial ovarian cancer treated in the first affiliated hospital of Zhengzhou University from September 2017 to June 2019.All patients underwent satisfactory tumor cytoreductive surgery(residual lesion diameter<lcm),and were pathologically confirmed.Staging adopted the Federation International of Gynecology and Obstetrics(FIGO,2014)clinical staging criteria.Patients were divided into three groups using a random number table,and there were 46 cases in group A,38 cases in group B and 42 cases in group C.2.Research method:On the first day of chemotherapy,all were given intravenous infusion of paclitaxel(135mg/m2).On the second day of chemotherapy,patients in group A received intravenous infusion of carboplatin(AUC=5),and in group B,carboplatin was given intraperitoneally(AUC=5),and patients in group C received intraperitoneal chemotherapy with cisplatin(100mg/m2),all patients in three groups received 6 courses of chemotherapy.The efficacy,toxicity,and quality of life of the three groups were compared.The follow-up date was from September 2017 to December 2019,and the follow-up period was 4 to 28 months,and the recurrence and survival time were recorded.3.Statistical methods:SPSS 24.0 statistical software was used for data analysis.F-test was used to analyze quantitative data,chi-square test was used to analyze qualitative data,Log-rank test was used to compare survival time.?=0.05 was used as the test level.Results1.The ages of patients in group A,group B and group C were(59.07±1.76)years old,(60.78±2.58)years old and(60.25±2.17)years old.There were no statistical differences in the age,stage,pathological type,degree of differentiation and surgical approach among three groups(P>0.05);2.The efficient rates of patients in groups A,B,and C were 82.61%(38/46),86.84%(33/38),88.10%(37/42).There was no significant difference among three groups(P>0.05);3.There were no significant differences in the incidence of grade ??? bone marrow suppression and grade ??? liver and kidney dysfunction among the three groups(P>0.05).The incidence of grade ??? abdominal pain and grade ???gastrointestinal reactions in group C were higher than those in group A and group B,and the differences were statistically significant(P<0.05).The incidence of grade ??? phlebitis in group A was higher than that in group B and group C,and the differences were statistically significant(P<0.05);4.The proportions of patients with improved,stable,and reduced quality of life in group A were 36.96%(17/46),50.00%(23/46),13.04%(6/46);the corresponding patients in group B accounted for 36.84%(14/38),44.74%(17/38),18.42%(7/38);the corresponding patients in group C were 42.86%(18/42),47.62%(20/42),9.52%(4/42).There was no significant difference among the three groups(P>0.05);5.The recurrence rates of effective patients in groups A,B,and C were:39.47%(15/38),39.39%(13/33),43.24%(16/37);the median progress-free survival time of groups A,B,and C were 20 months,21 months and 21 months,and the difference was not statistically significant(P>005);the median overall survival time of groups A,B,and C were 25.8 months,27 months,and 26 months,the difference was not statistically significant(P>005).ConclusionThe study shows that for patients with stage ??? epithelial ovarian cancer who have received satisfactory tumor cytoreductive surgery,intraperitoneal chemotherapy is similar to intravenous chemotherapy,but intraperitoneal chemotherapy can reduce the incidence of phlebitis.In addition,carboplatin and cisplatin intraperitoneal chemotherapy have similar efficacy and prognostic effects,but carboplatin has a less toxic effect and can be clinically promoted for intraperitoneal chemotherapy. |
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