化疗联合腹部高频热疗治疗晚期卵巢癌伴腹水的临床研究

Clinical Study of Chemotherapy Combined with High Frequency Thermo-therapy in Treatment of Advanced Ovarian Carcinoma with Ascites

目的：观察用多西他赛全身化疗和卡铂腹腔灌注化疗联合腹部高频热疗治疗晚期卵巢癌腹水患者的临床疗效及毒副反应。方法：34例晚期卵巢癌腹水患者,18例采用多西他赛全身化疗＋卡铂腹腔灌注化疗,16例用多西他赛全身化疗＋卡铂腹腔灌注化疗联合腹部高频热疗。多西他赛75 mg/m2,静脉滴注第1天,卡铂AUC=5,腹腔灌注给药第1天,高频热疗在腹腔灌注卡铂后2小时进行,以后隔日1次,21天为1周期,4周期后评价疗效。结果：常规化疗组的有效率为55.6%,高频热疗组的有效率为87.5%,两组差异有统计学意义（P〈0.05）;KPS评分,常规化疗组的改善率为61.1%,高频热疗组的改善率为93.8%,两组差异有统计学意义（P〈0.05）;化疗过程中的主要毒副反应是胃肠道反应、白细胞减少、血小板减少和脱发,差异无统计学意义（P〉0.05）;从第二周期化疗开始,高频热疗组腹水消退的患者明显较常规化疗组增多,两组间差异有统计学意义（P〈0.05）。结论：用多西他赛全身化疗和卡铂腹腔灌注化疗联合腹部高频热疗可显著提高晚期卵巢癌腹水患者的治疗效果、改善患者的生活质量和控制腹水的生长,而不增加毒副作用。

Objective： To observe the clinical effects of systemic chemotherapy with Docetaxel and intraperitoneal chemotherapy with Carboplatin combined with high frequency thermo-therapy in treatment of advanced ovarian carcinoma with aseites. Methods： 34 cases of advanced ovarian carcinoma with aseites were enrolled in our study. 18 patients accepted systemic chemotherapy with Docetaxel and intraperitoneal chemotherapy with Carboplatin（ control group）. The others accepted the same regimen of chemotherapy combined with high frequency thermo-therapy（ therapeutic group）. Docetaxel was given 75mg/m^2 intravenously on day 1, and Garboplatin （ AUC = 5） was qiven intmpefitoneally on days 1, High frequency thermo-therapy was given 2 hours after carboplatin and once every other day. Chemotherapy was repeated every 21 days as one cycle. Effects was evaluated after 4 cycles of treatment. Results： The overall response rates were 55.6% in the control group and 87.5% in therapeutic group. The difference were significant（ P 〈 0.05 ）. The improvement rate of KPS grade was 61.1% and 93.8% in control group and therapeutic group respectively. There were significant difference between them（P 〈 0.05）. The major side effects were gastrointestinal reaction,leucopenia,thrombecytopenia and alopecia. No significant difference were observed between these two groups （ P 〉 0.05 ）. From the second cycle, more patients in therapeutic group were observed with decreased ascites than those in control group. There were significant difference （ P 〈 0.05 ）. Conclusion： Systemic chemotherapy with Doeetaxel and intraperitoneal chemotherapy with Carboplatin combined with high frequency thermo-therapy is an effective way to treat advanced ovarian carcinoma with ascites. It can improve life quality of patients, suppress the growth of ascites without increasing side effets.