紫杉醇腹腔内灌注联合康莱特治疗晚期肝癌腹腔积液疗效观察

Paclitaxel Intraperitoneal Chemotherapy Combined with Intravenous Kanglaite in Treating Malignant Ascites of Advanced Hepatic Carcinoma

目的观察单药紫杉醇腹腔内灌注化疗联合康莱特注射液治疗晚期肝癌腹腔积液的疗效及安全性。方法选取24例晚期肝癌伴恶性腹腔积液患者,应用紫杉醇60 mg/m2＋0.9%氯化钠溶液1 500~2 000 m l腹腔内灌注,1次/周,共4周;同时给予康莱特注射液100 m l,连用10 d。按照世界卫生组织（WHO）标准评价近期疗效、生活质量及不良反应。结果 24例患者治疗4个周期后,9例（37.5%）患者完全缓解,8例（33.3%）部分缓解,总有效率为70.8%;生活质量显著改善9例（36.0%）,改善14例（58.3%）。不良反应：Ⅰ~Ⅱ度骨髓抑制20例,Ⅰ~Ⅲ度腹胀、腹痛9例,Ⅰ~Ⅱ度恶心、呕吐3例。结论紫杉醇腹腔内灌注化疗联合康莱特注射液治疗晚期肝癌腹腔积液相对安全有效,且能明显改善患者的生活质量。

Objective The aim of this study is to discuss the efficacy and safety of the treatment of malignant ascites in advanced hepatic carcinoma with intraperitoneal Paclitaxel and intravenous Kanglaite. Methods Twenty - four cases of advanced hepatic carcinoma patients with malignant ascites were enrolled and Paclitaxel （60 mg/m2 ） resovled in normal saline （ 1 500 ~ 2 000 ml） was administered via intraperitoneal injection weekly for 4 weeks. Kanglaite （ 100 ml/d） was used on the first day of the first chemotherapy cycle for 10 consecutive days. Short -term efficacy, adverse reactions, and the quality of life were evalua ted according to WHO criteria. Results After four treatment cycles, complete remission was seen in 9 （37. 5 % ） out of the 24 patients and partial remission was observed in 8 （33.3%） cases, with a total effective rate of 70. 8%. Quality of life was im proved remarkably in 9 （36.0%） cases and improved in 14 （58.3%） cases. Grade I - II leucopenia was noted in 20 cases, grade I-Ⅲabdominal pain was found in 9 cases, and another 3 cases suffered from grade I- Ⅱ nausea and vomi- ting. Conduslon Intraperitoneal chemotherapy of Paclitaxel combined with intravenous Kanglaite is effective and relatively safe in treating malignant ascites of adavanced hepatic carcinoma, which improves the therapeutic effects, reduces the side effects of chemotherapy, and improves the quality of life of the patients.