循环热灌注化疗治疗晚期胃癌合并腹腔积液的临床研究

Clinical Research on Continuous Hyperthermic Perfusion in the Treatment of Peritoneal Effusion Induced by Gastric Carcinoma

目的:观察腹腔循环热灌注联合化疗治疗晚期胃癌合并腹腔积液的有效性和安全性。方法:将102例解放军309医院肿瘤科2008年9月至2011年8月收治的胃癌合并腹腔积液患者随机分为腹腔热灌注化疗组和单纯化疗组。所有患者均应用多西紫杉醇75 mg/m^2静脉点滴,d1,每3周重复一次。腹腔热灌注化疗组同时腹腔内给予顺铂注射液40 mg/m^2热灌注化疗,每周重复一次,连用3次。单纯化疗组给予顺铂注射液40 mg/m^2腹腔热灌注化疗,每周重复一次,连用3次后观察疗效和不良反应。结果:联合组与单药者治疗有效率分别为69.23%和46.00%(P<0.05),治疗后两组KPS评分提高率分别为63.46%和40.00%(P<0.05)两组的主要不良反应率类似,主要为恶心、呕吐和白细胞下降。结论:热灌注化疗治疗胃癌所致恶性腹腔积液疗效确切,同时可改善患者生活质量,且不良反应较低,值得临床推广应用。

Objective： To evaluate the effect and safety of the hyperthermic pe^usion cycle of abdominal space with chemotherapy in the treatment of malignant peritoneal effusion induced by gastric carcinoma. Methods： A total of 102 cases of malignant peritoneal effusion were randomly divided into combined （ n = 52 ） and single-agent （ n = 50 ） groups. Based on the systemic treatment （ 75 mg/m2 docetaxel on day 1 every 3 weeks ）, the combined group was given coelom hyperthermic perfusion extracorporeal circulatory system combined with cisplatin （ 40 mg/m2 ） once a week for 3 weeks. The single-agent group was treated with cisplatin hyperthermic peritoneal perfusion. The treatment effect and toxicities were assessed. Results： The response rate was 69.23 % in the combined group and 46.00 % in the single-agent group （ P 〈 0.05 ）. The improvement rates of the Karnofsky performance score were 63.46 % and 40.00 %, respectively （ P 〈 0.05 ）. The main toxicities in the two groups were nausea/vomiting and leucopenia. Conclusion： Continuous hyperthermic perfusion is safe and effective for malignant peritoneal effusion induced by gastric carcinoma. It is suitable for clinical treatment application.