重组人血管内皮抑素联合顺铂腹腔灌注治疗恶性腹水的临床观察

Endostar combined with cisplatin abdominal cavity irrigation in the treatment of malignant ascites

目的:观察腹腔内注入抗肿瘤新药重组人血管内皮抑制素注射液(恩度)联合顺铂(cisplatin,DDP)治疗恶性腹水的临床疗效和不良反应。方法:于2010年1月至2011年1月收集120例恶性腹水患者按腹水严重程度平均分为4组,治疗组腹部经B超定位后行腹腔穿刺置单腔中心静脉导管引腹水后,治疗组1采用恩度30mg/m2+生理盐水500ml,腹腔灌注3小时,第三日放腹水后予以顺铂45mg/m2+生理盐水500ml腹腔灌注,夹管两日后放腹水,7天为一个疗程,连续5个疗程。治疗组2以恩度30mg/m2+生理盐水500ml,腹腔灌注3小时,夹管两日后放水为一个疗程,每7天一次,连续5个疗程;治疗组3以顺铂45mg/m2+生理盐水500ml腹腔灌注,夹管两日后放水为一个疗程,每7天一次,连续5个疗程;对照组为临终关怀对症处理组,不进行针对肿瘤及腹水的治疗,5周后评价。结果:治疗组1、2、3和对照组的RR分别为57.5%、30.0%、22.5%和0%(P<0.05),疾病控制率(DCR)分别为75.0%、45.0%、35%和5.0%(P<0.05)。毒性反应4组比较(P>0.05)。结论:重组人血管内皮抑制素注射液联合顺铂能较好地控制恶性腹水,减轻临床症状;不增加化疗药物的不良反应。

Objective：To observe the effect of rh-endostatin（endostar）combined with cisplatin（DDP）to treat malignant ascites.Methods： All 120 cases of malignant ascites from were divided into four groups.Treatment groups underwent abdominal positioning by B-abdominal puncturing single lumen central venous catheter after the leading ascites.Treatment group 1 was treated by endostar 30mg/m2 ＋ physiological saline 500ml,pouring into the abdominal cavity for 3 hours,after the third day,puting out the ascites,giving DDP 45mg/m2 ＋ physiological saline 500ml.Treatment group 2 was treated by endostar 30mg/m2 ＋ physiological saline 500ml,pouring into the abdominal cavity for 3 hours.After two days,putting out the ascites as a treatment course,once every 7 danys.Treatment group 3 DDP 45mg/m2 ＋ physiological saline 500ml abdominal cavity irrigation.After two days,putting out the ascites as a treatment course,once every 7 danys.The contrast group to the deathbed care is just right for the treatment group.Results： Treatment group 1,2,3 and contrast group＇ RR is were 57.5%,30.0%,22.5% and 0%（P0.05）,DCR were 75.0%,45.0%,35% and 5.0%（P0.05）.The toxicity in four groups P0.05.Conclusion： Endostar combined with cisplatin abdominal cavity irrigation can control the malignant ascites,reducing symptoms;not increasing adverse effects of chemotherapy.