本文關(guān)鍵詞：原發(fā)性卵巢鱗癌23例臨床分析　出處：《廣西醫(yī)科大學(xué)》2017年碩士論文　論文類(lèi)型：學(xué)位論文

  更多相關(guān)文章： 原發(fā)性卵巢癌 鱗狀細(xì)胞癌 術(shù)前診斷 治療 預(yù)后

【摘要】：目的:原發(fā)性卵巢鱗癌是一種發(fā)生于卵巢部位的鱗狀細(xì)胞癌,為罕見(jiàn)的惡性腫瘤,該病預(yù)后較其他卵巢上皮癌差。其發(fā)病機(jī)制、病因仍不明確,臨床表現(xiàn)無(wú)特異性,該疾病早期診斷困難,術(shù)前無(wú)有效的輔助診斷方法,需手術(shù)病理明確診斷,可誤診為良性腫瘤而延誤治療或未得到有效的手術(shù)治療,目前尚缺乏規(guī)范的診療方案,本文回顧性分析23例原發(fā)性卵巢鱗癌的臨床資料,總結(jié)其特點(diǎn),提高各位臨床醫(yī)師對(duì)此類(lèi)腫瘤的認(rèn)識(shí),得到重視,以幫助本病患者得到更好的治療。方法:收集1997年1月至2017年1月廣西醫(yī)科大學(xué)附屬腫瘤醫(yī)院、玉林市腫瘤醫(yī)院和玉林市第一人民醫(yī)院收治的資料較為完整的原發(fā)性卵巢鱗癌共23例,并對(duì)其腫瘤的一般特點(diǎn)、臨床表現(xiàn)、輔助檢查、治療方法及預(yù)后進(jìn)行回顧性分析。結(jié)果:1.腫瘤特點(diǎn):23例患者的發(fā)病年齡為35-82歲,主要集中在40-60年齡段內(nèi),中位年齡為54.00歲,平均年齡55.30歲。以絕經(jīng)為主,未絕經(jīng)人數(shù)與絕經(jīng)人數(shù)比例為1:2.8,平均絕經(jīng)時(shí)間為10.94年,PSCC主要發(fā)生于絕經(jīng)15內(nèi)年。腫瘤的發(fā)生主要來(lái)源于成熟畸胎瘤鱗癌變(SCC-MCT)占82.61%%,以單側(cè)為主(86.96%),左側(cè)多見(jiàn)(60.00%)。腫瘤直徑5.3-21cm,平均直徑為11.5cm。腫瘤分化程度以G3為主(65.22%),G(17.39%),G1(17.39%)。無(wú)論腫瘤直徑的大小,腫瘤分化程度均以G3為主。2.臨床表現(xiàn):23例PSCC患者,臨床分期以中早期(Ⅰ、Ⅱ期)為主。無(wú)論期別早晚,以下腹部脹痛為主要臨床表現(xiàn),且可為唯一臨床表現(xiàn),可伴有抗生素治療不理想、不明原因的反復(fù)發(fā)熱,以及伴有排便改變、腰痛、干咳氣促。可合并有不同程度的貧血以及腎功能不全。3.輔助檢查:23例PSCC患者進(jìn)行了腺鱗癌腫瘤標(biāo)志物的檢查,其中SCC-Ag、CYFRA21-1、CA125的陽(yáng)性率相對(duì)較高,分別為SCC-Ag陽(yáng)性10例(43.48%),CYFRA21-1陽(yáng)性10例(43.48%),CA125陽(yáng)性12例(52.17%),其他腫瘤標(biāo)志物均有不同程度及比例的升高。B超主要表現(xiàn)為盆腔的混合性包塊,CT、MR主要表現(xiàn)為附件區(qū)實(shí)性或囊實(shí)性占位,囊壁增厚明顯,可有不同程度的強(qiáng)化。4.治療情況不同臨床分期患者的治療情況。(1)ⅠA期4例,其中4例均為手術(shù)+化療。(2)ⅠC期5例,其中2例手術(shù),3例為手術(shù)+化療。(3)ⅡA期1例,其中1例為手術(shù)+化療。(4)ⅡB期8例患者,其中2例手術(shù),5例手術(shù)+化療,1例化療。(5)ⅢB期2例,2例均為手術(shù)+化療。(6)ⅢC期3例,3例均為手術(shù)+化療。不同臨床分期患者的手術(shù)情況及術(shù)后病理情況:23例PSCC患者中,行全子宮+雙附件切除術(shù)的有19例。其中ⅠA期4例,ⅠC期4例,ⅡA期1例,ⅡB期5例,ⅢB期2例,ⅢC期3例。1例ⅡB期未切除子宮及附件,1例ⅠC期、2例ⅡB期例只切除了附件。行腹膜后淋巴結(jié)切除術(shù)的有13例,其中ⅠA期3例,均行盆腔淋巴結(jié)清掃+腹主動(dòng)脈旁淋巴結(jié)切除術(shù);ⅠC期4例,2例行盆腔淋巴結(jié)切除術(shù),2例行盆腔淋巴結(jié)清掃+腹主動(dòng)脈旁淋巴結(jié)切除術(shù);ⅡA期1例行盆腔淋巴結(jié)清掃術(shù);ⅡB期4例,1例行盆腔淋巴結(jié)清掃術(shù),3例行盆腔淋巴結(jié)清掃+腹主動(dòng)脈旁淋巴結(jié)切除術(shù)。除了腹膜后淋巴結(jié)切除,其中有1例ⅡB期行腸系膜淋巴結(jié)切除,1例ⅢC期行腸周淋巴結(jié)及腸系膜淋巴結(jié)的切除,12例術(shù)后病理均未示腫瘤轉(zhuǎn)移,1例ⅢC期腹主動(dòng)脈旁淋巴結(jié)轉(zhuǎn)移,1例腸周淋巴結(jié)轉(zhuǎn)移,2例腸系膜淋巴結(jié)均未見(jiàn)轉(zhuǎn)移。行大網(wǎng)膜切除術(shù)的有13例,其中ⅠA期2例,ⅠC期4例,ⅡB期4例,ⅢC期2例,11例術(shù)后病理未示腫瘤轉(zhuǎn)移,2例示有腫瘤侵犯,且均為ⅢC期。行闌尾切除術(shù)的有6例,其中ⅠC期3例、ⅢB期1例、ⅢC期2例,6例術(shù)后病理均未示腫瘤轉(zhuǎn)移。不同化療方案的統(tǒng)計(jì)情況及不同臨床分期患者的化療情況:23例PSCC患者中18例進(jìn)行了化療,其中1例為單藥化療,17例為聯(lián)合化療,其中按卵巢上皮癌方案化療的有13例,按卵巢生殖細(xì)胞惡性腫瘤方案化療的有4例。(1)ⅠA期4例,1例術(shù)前予BEP方案行新輔化療1程,術(shù)后BEP方化療4程,1例于術(shù)中順鉑腹腔灌注+環(huán)磷酰胺靜脈化療1程,術(shù)后予BVP方案、BEP方案化療各1程;1例于術(shù)后予紫杉醇+奈達(dá)鉑方案化療7程;1例于術(shù)后予紫杉醇+奈達(dá)鉑方案化療6程。(2)ⅠC期5例,3例未化療,1例于術(shù)后1月因腫瘤未控予DC方案化療1程,化療后予腫瘤細(xì)胞減滅術(shù),再予術(shù)后DC方案化療共5程。1例于術(shù)后分別予DP,多西他賽+奧沙利鉑化療1程、5程。(3)IIA期1例,于術(shù)后予TP方案化療1程未繼續(xù)化療,復(fù)發(fā)后予TP方案化療6程。(4)IIB期8例,2例未化療,1例于活檢術(shù)后予紫杉醇+洛鉑方案化療1程;2例分別于術(shù)后予DP方案化療2、6程。2例于術(shù)后予TP方案化療2、3程,因化療毒副反應(yīng)更換為T(mén)C方案繼續(xù)化療2程。1例于術(shù)后予紫杉醇+奈達(dá)鉑方案化療2程,未繼續(xù)治療10個(gè)月后復(fù)發(fā),復(fù)發(fā)后予紫杉醇+奈達(dá)鉑方案化療8程,10個(gè)月后二次復(fù)發(fā),更改多西他賽+奧沙利鉑方案化療4程。(5)IIIB期2例,1例術(shù)后予洛鉑化療,具體不詳,1例于術(shù)后CTX+DDP方案化療3程,BEP方案化療1程。(6)IIIC期3例,1例于術(shù)后予DP方案化療8程,1例于再次腫瘤細(xì)胞減滅術(shù)后予DP方案化療3程,因腫瘤未控更改脂質(zhì)體阿霉素+奈達(dá)鉑化療1程,1例于術(shù)后TP方案化療3程、BEP方案化療3程,復(fù)發(fā)手術(shù)后予DC方案化療3程,因腫瘤進(jìn)展更換長(zhǎng)春瑞濱+替吉奧化療3程。5.隨訪及預(yù)后(1)ⅠA期4例,病例序號(hào)1-4。病例1:患者發(fā)病后1個(gè)月進(jìn)行了手術(shù)治療(子宮+雙附件切除術(shù)),術(shù)中予腹腔灌注化療,術(shù)后3周予化療1程,之后未繼續(xù)遵囑化療,5個(gè)月后腫瘤進(jìn)展,腫瘤進(jìn)展后予化療1程,未繼續(xù)治療,最終死亡,生存時(shí)間為13個(gè)月。病例2:患者發(fā)病1個(gè)月進(jìn)行了手術(shù)治療(患側(cè)附件切除),因術(shù)后病理提示惡性,于1個(gè)月后補(bǔ)充了分期手術(shù),術(shù)后未遵囑化療,12個(gè)月后出現(xiàn)陰道殘端、盆腔復(fù)發(fā)、腹膜后多發(fā)淋巴結(jié)轉(zhuǎn)移、全身多處骨轉(zhuǎn)移,復(fù)發(fā)后予化療7程,期間腫瘤部分緩解,后因小腸陰道殘端瘺未能繼續(xù)化療,�；�2個(gè)月后腫瘤繼續(xù)進(jìn)展,最終死亡,生存時(shí)間為29個(gè)月。病例3:患者發(fā)病1年進(jìn)行了手術(shù)治療(患側(cè)附件切除),因術(shù)后病理提示惡性,于5周后補(bǔ)充分期手術(shù),術(shù)后化療6次,目前無(wú)瘤生存,生存時(shí)間為43個(gè)月。病例4:患者發(fā)病2個(gè)月后行手術(shù)(患側(cè)附件切除),因術(shù)后病理提示惡性,且影像學(xué)考慮有腫瘤殘留,術(shù)后2周行化療1程,化療后5周補(bǔ)充分期手術(shù),術(shù)后繼續(xù)化療4程,目前無(wú)瘤生存,生存時(shí)間為57個(gè)月。(2)ⅠC期5例,病例序號(hào)5-9。病例5:患者發(fā)病后4個(gè)月行手術(shù)治療,術(shù)后1個(gè)月出現(xiàn)腫瘤進(jìn)展:未繼續(xù)治療,最終死亡,生存時(shí)間10個(gè)月。病例6:患者發(fā)病4年余行手術(shù)治療,要求不擴(kuò)大手術(shù)及不進(jìn)行化療,目前無(wú)瘤生存,生存時(shí)間為74個(gè)月。病例7:患者發(fā)病3周進(jìn)行手術(shù)治療,術(shù)后出現(xiàn)下肢血栓未能進(jìn)一步治療,術(shù)后1個(gè)月出現(xiàn)腫瘤進(jìn)展,乙狀結(jié)腸轉(zhuǎn)移,盆腔轉(zhuǎn)移,術(shù)后2個(gè)月先予化療1程,化療后1個(gè)月進(jìn)行了腫瘤細(xì)胞減滅術(shù),腫瘤細(xì)胞減滅術(shù)后化療5程,化療期間腫瘤繼續(xù)進(jìn)展,最終死亡,生存時(shí)間為18個(gè)月。病例8:患者發(fā)病1個(gè)月行手術(shù)治療,術(shù)后8天開(kāi)始予化療共6程,目前無(wú)瘤生存,生存時(shí)間12個(gè)月。病例9:患者發(fā)病予手術(shù)治療,術(shù)后拒絕化療,已失訪。(3)ⅡA期1例,病例序號(hào)10:患者發(fā)病后進(jìn)行了手術(shù)治療,術(shù)后化療1程,未遵囑繼續(xù)化療,10個(gè)于后發(fā)現(xiàn)肝轉(zhuǎn)移,行TP方案化療6療程,目前存活,生存時(shí)間17個(gè)月。(4)ⅡB期7例,病例序號(hào)11-14。病例11:患者發(fā)病2月行開(kāi)腹活檢確診,后予化療1程,因患者合并癥嚴(yán)重且身體狀況差未繼續(xù)治療,最終死亡,生存時(shí)間5個(gè)月。病例12:患者發(fā)病后即予手術(shù)治療,術(shù)后化療5程,因化療毒副反應(yīng)未繼續(xù)化療,停止化療后2月腫瘤進(jìn)展,最終死亡,生存時(shí)間12個(gè)月。病例13:患者發(fā)病2個(gè)月后行手術(shù)治療,因不同意化療未繼續(xù)治療,術(shù)后5個(gè)月出現(xiàn)腫瘤進(jìn)展,最終死亡,生存時(shí)間12個(gè)月。病例14:患者發(fā)病2周行手術(shù)治療(患側(cè)附件切除),術(shù)后病理提示惡性,1個(gè)月后行腫瘤細(xì)胞減滅術(shù),目前仍存活,繼續(xù)治療,生存時(shí)間4個(gè)月。病例15:患者發(fā)病1月予腹腔灌注化療,化療后2個(gè)月行手術(shù)治療,術(shù)后化療1程,為按時(shí)繼續(xù)化療,化療后10個(gè)月腫瘤盆腔復(fù)發(fā),復(fù)發(fā)后予8程化療,療效評(píng)價(jià)腫瘤緩解,8個(gè)月后腫瘤二次復(fù)發(fā),繼續(xù)化療4程,腫瘤繼續(xù)進(jìn)展,最終死亡,生存時(shí)間39個(gè)月。病例16:患者發(fā)病3周行手術(shù)治療,術(shù)后予2程化療,因體質(zhì)差未繼續(xù)化療,目前無(wú)瘤存活,生存時(shí)間8個(gè)月。病例17:患者發(fā)病2個(gè)月后行手術(shù)治療(雙側(cè)附件切除),1個(gè)月后補(bǔ)充分期手術(shù),術(shù)后予化療6程,目前無(wú)瘤生存,生存時(shí)間22個(gè)月。病例18:患者發(fā)病后行手術(shù)治療(腹腔鏡雙側(cè)卵巢切除術(shù)),術(shù)后病理提示卵巢良性腫瘤(未見(jiàn)病理報(bào)告單),1個(gè)月后出現(xiàn)腸轉(zhuǎn)移并行乙狀結(jié)腸切除術(shù)+盆腔腫瘤切除術(shù),術(shù)后TP方案化療2個(gè)療程,最終死亡,生存時(shí)間8個(gè)月。(5)ⅢB期2例,病例序號(hào)19-20。病例19:患者發(fā)病后即行手術(shù)治療,術(shù)后5周開(kāi)始予化療共3程,化療后1個(gè)月出現(xiàn)陰道殘端、盆腔多發(fā)轉(zhuǎn)移,繼續(xù)予化療1程,患者體質(zhì)差,無(wú)法耐受繼續(xù)化療,腫瘤繼續(xù)進(jìn)展,最終死亡,生存時(shí)間11個(gè)月。病例20:患者發(fā)病2周行手術(shù)治療,術(shù)后予化療,療程不詳,因并發(fā)癥及化療副反應(yīng)嚴(yán)重為繼續(xù)治療,術(shù)后化療后隨診11個(gè)月腫瘤復(fù)發(fā),經(jīng)中醫(yī)治療無(wú)好轉(zhuǎn),最終死亡,生存時(shí)間為13個(gè)月。(6)ⅢC期3例,病例序號(hào)21-23。病例21:患者發(fā)病1個(gè)月進(jìn)行了手術(shù)治療,術(shù)后1個(gè)月開(kāi)始化療共7程目前存活,仍在繼續(xù)化療,療效評(píng)價(jià)腫瘤大部分緩解,生存時(shí)間為12個(gè)月。病例22:于術(shù)后1個(gè)月出現(xiàn)腫瘤快速進(jìn)展,再次予手術(shù)及術(shù)后輔助化療,化療過(guò)程中腫瘤療效評(píng)價(jià)進(jìn)展,最終死亡,生存時(shí)間10個(gè)月。病例23:患者發(fā)病后進(jìn)行了手術(shù)治療,術(shù)后分別予TP、BEP方案化療各3程,化療后1月考慮盆腔轉(zhuǎn)移。予行回盲部腫物根治性右半結(jié)腸切除術(shù),后予DP方案化療3程。療效評(píng)價(jià)為進(jìn)展,更換長(zhǎng)春瑞濱+替吉奧化療3程,最終患者死亡,生存時(shí)間22個(gè)月。對(duì)患者的生存分析結(jié)果顯示,SCC-Ag陽(yáng)性的患者的生存率比SCC-Ag陰性的患者低,預(yù)后更差。結(jié)論:PSCC是一種罕見(jiàn)類(lèi)型的卵巢癌,其組織來(lái)源多見(jiàn)于SCC-MCT。術(shù)前診斷PSCC仍具有挑戰(zhàn)性,易誤診漏診,對(duì)絕經(jīng)的中老年女性,腫瘤標(biāo)志物SCC-Ag陽(yáng)性、腫瘤直徑≥10cm、影像學(xué)檢查提示囊壁增厚,強(qiáng)化明顯的病例需引起重視,對(duì)于盆腔包塊的患者,SCC-Ag的檢查也是必要的,若考慮為卵巢畸胎瘤的患者還應(yīng)及時(shí)處理以免發(fā)生惡變。PSCC的術(shù)中冰凍切片檢測(cè)要求病理醫(yī)師除了仔細(xì)檢查其實(shí)質(zhì)部分,還應(yīng)關(guān)注囊壁厚度及結(jié)節(jié)部位,多點(diǎn)取材,并與手術(shù)醫(yī)師充分溝通以減少漏診。PSCC的治療采用手術(shù)聯(lián)合輔助化療,部分患者手術(shù)的實(shí)施原則參照卵巢上皮癌,對(duì)于早期(I期),若腫瘤破裂,進(jìn)行保留生育功能的手術(shù)應(yīng)慎重,術(shù)后是否需要輔助化療仍存在疑問(wèn),而中晚期的患者若需行腸切除術(shù),腹主動(dòng)脈旁淋巴結(jié)切除可能是有必要的�；煹姆桨付鄻�,目前無(wú)最佳化療方案,但均為紫杉醇類(lèi)+鉑類(lèi)化療方案為主,化療的患者可延緩復(fù)發(fā)及進(jìn)展的時(shí)間,化療患者預(yù)后較好,放療是否有助于PSCC的治療仍需進(jìn)一步探討。PSCC易進(jìn)展、復(fù)發(fā),SCC-Ag陽(yáng)性、進(jìn)展、復(fù)發(fā)及晚期的患者預(yù)后差,各臨床分期復(fù)發(fā)率均較高。
[Abstract]:Objective: primary squamous cell carcinoma of the ovary is a kind of squamous cell carcinoma occurring at the site of the ovary. It is a rare malignant tumor, and the prognosis is worse than that of other ovarian epithelial cancer. The pathogenesis, etiology is still not clear, no specific clinical manifestations, early diagnosis of the disease, no preoperative diagnosis methods, surgical pathology diagnosis, may be misdiagnosed as benign tumor and delayed treatment or surgical treatment has not been effective, there is a lack of standardized diagnosis and treatment scheme, this paper analyzed retrospectively the clinical data of 23 cases of primary ovarian carcinoma, summarizes its characteristics, improve your understanding of the tumor to clinicians, get attention, to help patients get better treatment of this disease. Methods: from January 1997 to January 2017 in the Affiliated Tumor Hospital of Guangxi Medical University, Yulin cancer hospital and Yulin First People's Hospital were complete data of primary ovarian carcinoma were 23 cases, and the treatment method of general characteristics of the tumor, clinical manifestation, auxiliary examination, and prognosis were retrospectively analyzed. Results: 1. the characteristics of tumor: the age of the 23 patients was 35-82 years old, mainly in the 40-60 age group, the median age was 54 years and the average age was 55.30 years old. The proportion of the number of menopause and menopause is 1:2.8, the average menopause time is 10.94 years, and PSCC mainly occurs in the 15 year of menopause. The tumor occurred mainly from the mature teratoma squamous cell carcinoma (SCC-MCT) (82.61%%), which was mainly on the unilateral (86.96%) side, and on the left side (60%). The diameter of the tumor was 5.3-21cm, with an average diameter of 11.5cm. The degree of tumor differentiation was G3 (65.22%), G (17.39%), and G1 (17.39%). No matter the size of the tumor, the degree of differentiation of the tumor was G3. 2. clinical manifestations: 23 cases of PSCC patients, the clinical stages were mainly in the middle early stage (stage I and II). No matter the stage sooner or later, following abdominal pain as the main clinical manifestations, and may be the only clinical manifestation, may be associated with antibiotic treatment is not ideal, unexplained recurrent fever, and accompanied by pain, dry cough, shortness of breath and defecation change. It can be combined with varying degrees of anemia and renal insufficiency. 3. auxiliary examination: 23 cases of PSCC patients with adenosquamous carcinoma of the tumor markers examined, the positive rate of SCC-Ag, CYFRA21-1 and CA125 were relatively high, SCC-Ag was positive in 10 cases (43.48%), 10 cases were CYFRA21-1 positive (43.48%), 12 cases were CA125 positive (52.17%), other tumor markers increased in varying degrees and the proportion of. The main manifestations of B-ultrasound are the mixed mass of pelvic cavity. CT and MR are mainly manifested in the solid or cystic mass in the appendage area, and the thickening of the wall of the capsule is obvious, which can be strengthened in varying degrees. 4. treatment of patients with different clinical stages. (1) there were 4 cases in phase I A, of which 4 were operated with chemotherapy. (2) there were 5 cases in stage I C, of which 2 cases were operated and 3 cases were operated plus chemotherapy. (3) 1 cases in phase II A, of which 1 were operated plus chemotherapy. (4) there were 8 patients in phase II B, of which 2 cases were operated, 5 cases were operated with chemotherapy, and 1 cases were treated with chemotherapy. (5) 2 cases in stage III B, 2 cases were all operation plus chemotherapy. (6) 3 cases in stage III C, 3 cases were all operation plus chemotherapy. The operation and postoperative pathology of patients with different clinical stages: 19 of the 23 PSCC patients underwent total uterine plus double annexectomy. There were 4 cases in stage I A, 4 in stage I C, 1 in stage II A, 5 in stage II B, 2 in stage III B, 3 in stage III C. 1 cases of unresected uterus and appendages in phase II B, 1 cases of stage I C and 2 cases of II B were removed. Retroperitoneal lymph node resection in 13 cases, including 3 cases of stage A underwent pelvic lymph node dissection + paraaortic lymph node resection; 4 cases of stage C, 2 cases of pelvic lymph node resection, 2 cases of pelvic lymph node dissection + paraaortic lymph node excision; II A of 1 cases with pelvic lymphadenectomy; 4 patients with stage B, 1 cases of pelvic lymph node dissection, 3 cases of pelvic lymph node dissection + paraaortic lymph node excision. In addition to the retroperitoneal lymph node resection, including 1 cases of stage II B for mesenteric lymph node resection, 1 cases of stage C underwent intestinal lymph node and mesenteric lymph node resection, postoperative pathology in 12 cases were not shown in tumor metastasis, 1 cases of stage C paraaortic lymph node metastasis, 1 cases of intestinal week lymph node metastasis, 2 cases of mesenteric lymph node metastasis were not found. Greater omentum resection in 13 cases, including 2 cases of stage A, 4 cases of stage C, 4 patients with stage B, 2 cases of stage C, 11 cases of postoperative pathology showed 2 cases with tumor metastasis, tumor invasion, and is the stage C. There were 6 cases of appendectomy, of which 3 cases in stage I C, 1 cases in stage III B, 2 cases in stage III C, and no tumor metastasis was found in 6 cases after operation. The statistics of chemotherapy and chemotherapy in different clinical stages of patients: 23 cases of PSCC patients in chemotherapy in 18 cases, including 1 cases of single drug chemotherapy, 17 cases were combined with chemotherapy, the chemotherapy according to ovarian cancer program in 13 cases, malignant germ cell tumors of ovary according to the scheme of chemotherapy in 4 cases. (1) 4 cases of stage A, 1 cases received BEP regimen for new auxiliary chemotherapy in 1, postoperative BEP chemotherapy 4, 1 cases in intraoperative intraperitoneal cisplatin + cyclophosphamide chemotherapy in 1, followed by BVP scheme and BEP chemotherapy in 1; in 1 cases after operation to paclitaxel and nedaplatin chemotherapy in 7; in 1 patients treated with paclitaxel and nedaplatin chemotherapy 6. (2) there were 5 cases of stage I C, 3 cases without chemotherapy, and 1 cases received DC chemotherapy 1 times after surgery in January. After chemotherapy, cytoreductive surgery was performed after chemotherapy, and then DC chemotherapy was given to 5 patients. 1 cases were treated with DP, docetaxel + oxaliplatin chemotherapy and 1 course, 5 course after operation. (3) 1 cases in IIA stage, and after the operation, the chemotherapy of TP regimen was not continued, and the relapse was given to the 6 course of TP regimen. (4) 8 cases in IIB stage, 2 cases without chemotherapy, 1 cases with paclitaxel plus luoplatin regimen 1 course after biopsy; 2 cases were treated with DP chemotherapy 2 and 6 course after operation. 2 cases were treated with TP chemotherapy 2 and 3 course after operation, and the chemotherapy side reaction was replaced by TC regimen to continue the 2 course of chemotherapy. 1 cases were treated with paclitaxel + nedaplatin chemotherapy 2 course after operation, and the recurrence after 10 months was not continued, and the relapse was given to purple.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R737.31

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