腹腔灌注化疗联合内生场热疗在胰腺癌恶性腹水中的应用研究

Intraperitoneal chemotherapy combined with internal field thermotherapy in treating malignant ascites in patients with pancreatic cancer

目的:评价腹腔灌注化疗联合内生场热疗在胰腺癌引起恶性腹水中的应用价值。方法:76例晚期胰腺癌合并恶性腹水患者随机分为两组,其中研究组在接受腹腔灌注化疗的同时应用内生场热疗治疗癌性腹水,对照组仅接受腹腔灌注化疗。结果:研究组完全缓解8例,部分缓解21例,稳定5例,进展4例,客观反应率为76%(29/38)。对照组完全缓解3例,部分缓解17例,稳定12例,进展6例,客观反应率为53%(20/38)。中位随访时间11.8个月,研究组和对照组中位生存时间分别为7.8个月及6.2个月,1年生存率分别为29%(11/38)和18%(7/38)。两组客观反应率、1年生存率比较差异有统计学意义(P均<0.05)。治疗过程中不良反应轻微,两组不良反应发生情况比较差异无统计学意义(P﹥0.05)。结论:在晚期胰腺癌合并恶性腹水患者中,腹腔灌注化疗联合内生场热疗治疗较常规单纯腹腔化疗疗效好,能延长患者生存期,并未增加不良反应。

Objective： To evaluate the efficacy of intraperitoneal chemotherapy combined with internal field thermotherapy in treating malignant ascites in patients with pancreatic cancer.Methods： Intraperitoneal chemotherapy was carried out on 76 pancreatic cancer patients with malignant ascites,among which 38 patients received combined internal field thermotherapy（experimental group）,while the other 38 patients received intraperitoneal chemotherapy alone（control group）.Results： In experimental group,complete response（CR）,partial response（PR）,stable disease（SD） and progressive disease（PD） were observed in 8,21,5 and 4 patients,respectively.While in control group,CR,PR,SD and PD were observed in 3,17,12 and 6 patients,respectively.With a median follow-up of 11.8 months,the median-survival time of experimental group and control group was 7.8 and 6.2 months,respectively,with survival rate of 29% and 18%,respectively.There were significant differences in these parameters between the two groups（P〈0.05）.Mild adverse events were observed in either group,with no significant difference（P〉0.05）.Conclusion： Intraperitoneal chemotherapy combined with internal field thermotherapy is more effective than intraperitoneal chemotherapy alone for pancreatic cancer patients with malignant ascites,without increase of adverse event.