ycle chemotherapy， CA125 levels in DDP group were lower than that in CBP group (P < 0.05)， but there were no significant difference between two groups after second，third or fourth cycle chemotherapy(P > 0.05). For the patients with gross residual disease， CA125 levels in DDP group were lower than that in CBP group after first or second cycle (P < 0.05)， but for the patients without gross residual disease， there were no significant difference between two groups after first， second or third cycle chemotherapy (P > 0.05). The rate of abdominal pain (I class) was higher in DDP group (40%，8/20) than that in CBP group (24%，4/17)， but there were no significant differences between two groups in the toxicities of hypoleukemia， digestive disturbance， liver function damage， renal function damage， phalacrosis or discontinuation of intraperitoneal chemotherapy. 【Conclusion】 Intraperitoneal chemotherapy with cisplatin or carboplatin was efficient and suitable for the advanced ovarian cancer after optimally cytoreductive surgery， but cisplatin lowered recent CA125 level sooner than carboplatin for those with small gross residual disease.
Key words： ovarian cancer; intraperitoneal chemotherapy; cisplatin; karboplatin
[J SUN Yat-sen Univ(Med Sci)，2009，30(5)：566-570]
卵巢癌是致死率排在首位的妇科肿瘤[1]。卵巢癌确诊时，75%患者已属晚期，彻底的肿瘤细胞减灭术加术后紫杉类和铂类的联合化疗是晚期卵巢癌患者标准的治疗方式，而腹腔化疗是其中的一种重要方式。经过几十年的研究，腹腔化疗方案已被NCCN(美国国家综合癌症网，National Comprehensive Cancer Network)推荐应用于彻底肿瘤细胞减灭术后的晚期卵巢癌。目前临床使用的腹腔化疗药物主要是顺铂(cisplatin，DDP)与卡铂(karboplatin，CBP)，而顺铂是腹腔化疗最常用的药物。在静脉化疗中，卡铂因有效率与顺铂相近、毒性反应更小而取代后者。但在腹腔化疗中卡铂能否取代顺铂仍有待于正在进行的对两者进行比较的Ⅲ期临床研究结果的证实[2]，而目前对卵巢癌腹腔化疗的研究基本上是围绕铂类药物的腹腔与静脉途径的比较，但尚未见腹腔化疗中卡铂与顺铂比较的相关研究报道。本研究病例为晚期卵巢癌术后使用顺铂或卡铂腹腔化疗联合艾素静脉化疗的患者，通过比较两组的癌抗原125(cancer antigen，CA125)的下降情况和药物不良反应来探讨顺铂与卡铂在晚期卵巢癌术后腹腔化疗中的近期作用。
1 材料与方法
1.1 一般资料
回顾性分析2004年1月至2008年9月中山大学附属第三医院妇科收治的卵巢癌病例共136 例。
1.1.1 病例入选标准 ①经术后病理组织学确诊为原发性上皮性卵巢癌患者;②在我院为初次手术治疗的晚期患者，术式为肿瘤细胞减灭术，残余病灶最大直径小于1 cm;③术前无化疗史
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