化疗联合顺铂腹腔热灌注治疗中晚期卵巢癌术后的效果

Post-operatively curative efficacy of chemotherapy combined with cisplatin hyperthermic intraperitoneal perfusion chemotherapy on mid- advanced ovarian cancer

目的探讨化疗联合顺铂腹腔热灌注治疗中晚期卵巢癌术后的效果。方法选取中晚期卵巢癌患者95例,全部患者均采用肿瘤细胞减灭术治疗,其中A组(30例)采用术前新辅助化疗联合术后TP方案化疗(围术期化疗),B组(32例)采用术后化疗联合顺铂(60 mg)腹腔热灌注治疗,C组(33例)采用围术期化疗联合顺铂腹腔热灌注治疗;比较3组临床疗效的差异。结果 C组手术时间、术中出血量和术后化疗疗程均明显低于B组,两组比较差异有统计学意义(P<0.05),C组PFS和KPS评分明显高于A、B组,差异有统计学意义(P<0.05),C组腹腔积液量明显低于A、B组,两组间比较差异有统计学意义(P<0.05),随着治疗时间的延长,B、C组外周血CD3+CD4+、CD3+CD56+、CD3+CD4+/CD3+CD8+呈上升趋势,腹腔热灌注治疗后,B、C组上述指标均明显高于治疗前(P<0.05),而A组治疗前后比较差异无统计学意义(P>0.05)。结论顺铂腹腔热灌注通过促进肿瘤细胞凋亡,以达到术后抗癌效果和改善生活质量,同时利用温热效应有效解除免疫抑制现象,值得临床推广应用。

Objective To investigate the post -operatively curative efficacy of chemotherapy combined with cis-platin hyperthermic intraperitoneal perfusion chemotherapy on mid -advanced ovarian cancer .Methods Ninety-five ca-ses with pathological proved mid -advanced ovarian cancer and cytoreductive therapy were selected , and divided into 3 groups;among whom regimen neoadjuvant chemotherapy combined with postoperative TP chemotherapy （ perioperative chemotherapy ） , postoperative chemotherapy combined with cisplatin （ 60 mg ） hyperthermic intraperitoneal perfusion chemotherapy , and perioperative chemotherapy combined with cisplatin hyperthermic intraperitoneal perfusion chemothera -py were given to those in Group A （n=30）, B （n=32） and C （n=33）, respectively.The clinical efficacy was com-pared.Results Significantly shorter operation time and postoperative chemotherapy duration , and less intraoperative blood loss were observed in Group C than those in Group A and B （ P＆lt;0.05）;so were significantly higher PFS and KPS , and lower ascites in Group C （P＆lt;0.05）.As the extension of treatment, peripheral blood CD3 ＋CD4＋, CD3 ＋CD56 ＋and CD3 ＋CD4 ＋/CD3 ＋CD8 ＋in Group B and C group were significantly increased , which were significantly higher after hy-perthermic intraperitoneal perfusion chemotherapy than pre -treatment （P＆lt;0.05）, while there was no significant differ-ence before and after the treatment in Group A group （P＆gt;0.05）.Conclusions The cisplatin hyperthermic intraperito-neal perfusion chemotherapy intensifies the anticancer efficacy and improves the life quality after surgery by inducing tumor apoptosis.The thermal effect can also alleviate immune suppression phenomenon .