洛铂联合多西他赛行肿瘤细胞减灭术加腹腔热灌注化疗治疗腹膜癌的临床观察

Clinical Observation of Cytoreductive Surgery plus Hyperthermic Intraperitoneal Chemotherapy with Lobaplatin and Docetaxel on Peritoneal Carcinoma

目的分析洛铂联合多西他赛行肿瘤细胞减灭术（cytoreductive surgery,CRS）加腹腔热灌注化疗（hyperthermic intraperitoneal chemotherapy,HIPEC）治疗腹膜癌（peritoneal carcinoma,PC）的围手术期安全性及疗效。方法 PC患者行CRS＋HIPEC治疗,药物为洛铂50 mg/m2、多西他赛60 mg/m2,加入12 000 ml 0.9%氯化钠溶液加热至（43±0.5）℃持续灌注60 min。记录术后6天体温和心率变化、围手术期不良事件、血常规及血生化指标、术后患者恢复情况及生存结果。结果 90例PC患者行95次CRS＋HIPEC,手术时间180~450 min（中位数485 min）;术后6天最高体温、心率分别为36.4℃~38.6℃（中位数37.5℃）、76~124 bpm（中位数100 bpm）,严重不良事件16例,包括围手术期死亡2例。中位生存期20.8月（95%CI：13.1~25.8月）,1、3、5年生存率分别为75.6%、45.6%、43.3%。结论洛铂联合多西他赛进行CRS＋HIPEC治疗PC安全性可接受,有助于延长患者生存期。

Objective To investigate the perioperative safety and efficacy of cytoreductive surgery （CRS） plus hyperthermic intraperitoneal chemotherapy（HIPEC） with lobaplatin （LBP） and docetaxel （TXT） on peritoneal carcinoma（PC） patients. Methods PC patients were treated with CRS＋HIPEC using LBP 50 mg/m2 and TXT 60 mg/m2 in 12000 ml of normal saline at （43＋0.5）% for 60 rain. Body temperature and heart rate were recorded for 6 d after CRS plus HIPEC. Perioperative adverse events, hematological, hepatic, renal and electrolytes parameters, patients recovery and survival outcomes were analyzed. Results 90 PC patients were treated with 95 CRS plus HIPEC procedures, with the median duration of 485 rain （180-450 min）. The highest temperature and heart rate during six postoperative days were 36.4-38.6℃（median 37.5 ℃） and 76-124 bpm（median I00 bpm）, respectively. Severe adverse events occurred in 16 patients, including two patients died during perioperation. The median OS was 20.8 months （95% CI： 13.1-25.8 months）, and the 1-, 3-, 5-year survival rates were 75.6%, 45.6%, 43.3%, respectively. Conclusion CRS＋HIPEC with LBP and TXT to treat PC is a feasible procedure with acceptable safety, and could prolong patients＇ survival.