射频热疗加腹腔热灌注化疗联合静脉双途径化疗治疗恶性腹水疗效分析

Radiofrequency chemohyperthermia combined with intravenous chemotheray for malig nant ascites

目的 :探讨射频热疗加腹腔热灌注化疗和静脉双途径化疗治疗恶性腹水的疗效和毒副反应。方法 :2 0例恶性腹水患者采用常规腹腔穿刺 ,放置中心静脉导管 ,尽量引流腹水彻底后 ,将 4 3℃无菌生理盐水 15 0 0～2 0 0 0ml加 5 FU 0 .5～ 1.0 g经导管快速滴入腹腔 ,第 1、4、8、11天 ,然后沿导管放置传感器进行腹腔温度的测定 ,随后行腹部SR 10 0 0型射频透热治疗 70分钟 ,并同时进行全身静脉化疗 ,奥沙利铂 10 0mg第 1、8天或顺铂 4 0～6 0mg第 1、8天 ,2 1天为一周期。 结果 :全组患者最高治疗温度为 4 3.5℃ ,最低治疗温度为 4 0 .5℃ ,平均治疗温度4 1.5℃。腹水有效率为 90 % (18/2 0 ) ,盆、腹腔肿瘤有效率为 5 8.8% (10 /17) ,全组患者中位生存期 10个月 ,一年生存率75 %。脂肪硬结发生率 2 0 % ,腹痛发生率为 2 5 % ,其他毒副反应较轻 ,能耐受。结论 :射频热疗加腹腔热灌注化疗和静脉双途径化疗治疗恶性腹水疗效高 ,毒副反应轻 ,且对腹、盆腔肿瘤病灶也有较好的疗效 ,值得进一步的推广应用。

Purpose:To evaluate the efficacy and toleranc e of radiofrequency chemohyperthermia combined with intravenous chemotherapy for m alignant ascites. Methods:Twenty patients with malignant ascites received the tre atment .After abdominal cavity aspiration and infusion of hot 0.9% sodium chlori de injection 1 500-2 000 ml with 5-FU , Estimated the temperature of abdominal cavity was estimated with a sensor, then treated with SR-1000 radiofrequency h yperthermia for 70 minutes and chemotherapy at the same time.The radiofrequency chemohyperthermia with 5-FU 0.5-1.0 g was given d 1,4,8,11 and intravenous che motherapy with oxaliplatin 100 mg was given d 1,8 or cisplatin 40-60 mg d 1,8. Results:The average treatment temperature was 41.5℃ in 20 case s. The highest was 43.5℃ and lowest temperature was 40.5℃. The response rate o f ascites was 90%(18/20) The response rate of peritoneo-pelvic tumor was 58.8%( 10/17).1-year overall survival rate is 75%. The common side-effects were fat n ecrosis (20%) and adominal pain (25%). Conclusions:Radiofrequency chemohyperthermia combined with intr avenous chemotherapy appears to have a relatively high response with low side-e ffects for malignant ascites and good response for peritoneo-pelvic malignant t umors.