卵巢癌恶性腹腔积液TP方案静脉联合循环热灌注化疗临床疗效分析

发布时间：2018-11-12 16:19

【摘要】：目的恶性腹腔积液(malignant peritoneal ascites,MPE)是严重威胁晚期卵巢癌患者生存质量、生存时间的并发症之一。比较采用紫杉醇和顺铂静脉联合腹腔循环热灌注化疗与单纯腹腔灌注化疗治疗晚期卵巢癌合并恶性腹腔积液的临床疗效。方法将2008-04-2013-07开封市中心医院收住的68例晚期卵巢癌术后复发或无法行手术治疗(合并其他远处转移无法手术、或因心肺等基础疾病无法手术、或患者、家属拒绝手术者)、合并恶性腹腔积液的患者。按照随机原则分为观察组和对照组,每组各34例。观察组采用紫杉醇联合顺铂腹腔循环热灌注化疗,对照组采用紫杉醇联合顺铂单纯腹腔灌注化疗。比较两组临床疗效、生活质量、免疫功能指标、不良反应和生存率等。结果观察组和对照组客观缓解率分别为85.29%和58.82%,差异有统计学意义,χ~2=5.916 2,P0.05;应用SF-12生活量表评价,观察组患者在总体健康(t=3.498 6,P0.05)、精神健康(t=3.642 6,P0.05)和情感职能(t=17.523 2,P0.001)方面评分均高于对照组,差异有统计学意义;CD4和CD4/CD8水平,观察组治疗后高于治疗前(t=4.086 9,P0.05;t=2.647 9,P0.05),并高于对照组治疗后(t=4.279 1,P0.05;t=3.214 6,P0.05),差异有统计学意义;对照组治疗前后各免疫功能指标水平比较,差异均无统计学意义,P0.05;观察组和对照组不良反应发生率分别为44.05%和47.00%,差异无统计学意义,χ~2=0.059 3,P0.05;治疗组与对照组相比,1、2和3年生存率均显示优势,但差异无统计学意义。结论紫杉醇静脉联合腹腔顺铂循环热灌注化疗治疗晚期卵巢癌疗效显著,毒副作用小,生存质量无明显下降,总体健康、精神健康、情感职能均有升高,有生存期优势,值得临床推广应用。
[Abstract]:Objective malignant peritoneal effusion (malignant peritoneal ascites,MPE) is a serious threat to the quality of life and survival time of patients with advanced ovarian cancer complications. To compare the clinical efficacy of paclitaxel and cisplatin combined with intraperitoneal circulatory hyperthermic chemotherapy and intraperitoneal infusion chemotherapy in the treatment of advanced ovarian cancer with malignant peritoneal effusion. Methods Sixty-eight patients with advanced ovarian cancer who were admitted to Kaifeng Central Hospital from April 2008 to July 2013-07 were treated with recurrence or failure to undergo surgical treatment (complicated with other distant metastases or unable to operate due to basic diseases such as cardiopulmonary disease, etc.) Patients with malignant peritoneal effusion. According to the random principle, they were divided into observation group and control group with 34 cases in each group. The observation group was treated with paclitaxel combined with cisplatin intraperitoneal circulation chemotherapy and the control group with paclitaxel combined with cisplatin intraperitoneal infusion chemotherapy. The clinical efficacy, quality of life, immune function index, adverse reaction and survival rate were compared between the two groups. Results the objective remission rates of the observation group and the control group were 85.29% and 58.82%, respectively. The difference was statistically significant (蠂 ~ 2 ~ (5.916 2) P 0.05). Using SF-12 life scale, the scores of overall health (t = 3.498-6P 0.05), mental health (t n = 3.642 6) and affective function (t = 17.523 2n P0.001) in the observation group were higher than those in the control group, and the scores of the patients in the observation group were higher than those in the control group (P < 0.05). The difference was statistically significant. The levels of CD4 and CD4/CD8 in the observation group after treatment were higher than those before treatment (t = 4.0869, P 0.05, P = 2.647, P 0.05), and higher than those in the control group, respectively (P < 0.05, P < 0.05). The difference was statistically significant. In the control group, there was no significant difference in the level of immune function before and after treatment (P0.05). The incidence of adverse reactions in the observation group and the control group was 44.05% and 47.00%, respectively. The 1-2 and 3-year survival rates in the treatment group were superior to those in the control group, but the difference was not statistically significant. Conclusion the efficacy of paclitaxel combined with intraperitoneal Cisplatin circulation perfusion chemotherapy in the treatment of advanced ovarian cancer is significant, with little side effect, no significant decline in quality of life, general health, mental health and emotional function, and has the advantage of survival period. It is worth popularizing and applying in clinic.
【作者单位】：开封市中心医院肿瘤诊疗中心;
【基金】：开封市科技攻关计划(HO.130324)
【分类号】：R737.31

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