热灌注基础上腹腔内贝伐珠单抗联合化疗治疗恶性腹水的临床观察

Clinical study in treatment of malignant ascites with intraperitoneal injection bevacizumab and 5-FU combined with intraperitoneal hyperthermic perfusion chemotherapy

目的观察在热灌注的基础上腹腔内注射贝伐珠单抗(安维汀)联合腔内化疗治疗恶性腹水患者的疗效和安全性。方法 57例恶性腹水患者在热灌注的基础上随机分为腔内贝伐珠单抗联合化疗治疗组(治疗组)和腔内单纯化疗治疗组(对照组)。治疗前均先排尽腹水,以43～45.0℃灭菌0.9%生理盐水注入腹腔,持续有效循环40 min以上,排尽灌注液后治疗组在腹腔内注入贝伐珠单抗300 mg和氟尿嘧啶1 g。对照组除不加入贝伐珠单抗外,其余同治疗组。结果在可评价的57例患者中,治疗组总有效率为85.71%,对照组58.62%,P<0.05。全组患者耐受良好,无严重不良反应。结论热灌注基础上腹腔内贝伐珠单抗联合化疗治疗恶性腹水优于腔内单纯化疗且安全可靠。

Objective To study the efficacy and safety of intraperitoneal injection bevacizumab and 5-FU combined with intraperitoneal hyperthermic perfusion chemotherapy in treatment of malignant ascites.Methods Fifty-seven cases of the patients with malignant ascites were randomly divided into group of intraperitoneal injection bevacizumab and 5-FU of malignant ascites（treatment group） and group of intraperitoneal injection only 5-FU（control group）.Ascites of the patients from the two groups were both exhausted first.Sterilization 0.9% saline with 43 to 45 ℃ was injected into the peritoneal cavity of all patients,constantly and effectively circulated more than 40 minutes,then the saline was exhausted.The patients in treatment group were accepted intraperitoneal injection with bevacizumab（avastin） 300 mg and 5-FU 1 g.The same therapy applied to the control group except adding bevacizumab.Results Among the evaluable 57 cases,the total effective rate of the treatment group was 85.71%,while 58.62% of the control group.Two groups had significant difference（P〈0.05）.All the patients were of good tolerance in whole therapy and no severe side effects happened.Conclusion The treatment of malignant ascites with intraperitoneal injection bevacizumab and 5-FU,combined with intraperitoneal hyperthermic perfusion chemotherapy is effective and secure.