腹腔热灌注化疗联合贝伐珠单抗治疗卵巢癌腹腔积液的疗效及生活质量评价

Effect and quality of life evaluation of intraperitoneal hyperthermic perfusion chemotherapy combined with bevacizumab in the treatment of ovarian cancer with peritoneal effusion

目的探讨腹腔热灌注化疗联合贝伐珠单抗治疗卵巢癌腹腔积液的疗效及生活质量。方法选取临朐县人民医院2013年6月至2015年6月间收治的80例卵巢癌腹腔积液患者,采取随机数字表法分为观察组和对照组,每组40例。两组患者均给予紫杉醇联合卡铂行全身化疗,同时给予腹腔内顺铂热灌注化疗,以6周为1个疗程。观察组患者在此基础上于每次热灌注化疗腹腔内注入贝伐珠单抗,6周为1个疗程。对比两组患者的临床疗效,治疗前后腹水中血管内皮生长因子(VEGF)水平,两组患者的生活质量及不良反应。结果与对照组相比,观察组患者的有效率和疾病控制率明显增加,差异均有统计学意义(P<0.05)。与治疗前相比,两组患者治疗后VEGF水平均有所降低;治疗后,观察组患者的VEGF水平低于对照组,差异有统计学意义(P<0.05)。与对照组相比,观察组患者躯体功能、角色功能、认知功能、情绪功能和社区功能评分均明显降低,差异均有统计学意义(均P<0.05)。两组患者发热、白细胞减少、恶心呕吐、疼痛、疲乏和体重减轻发生率的差异均无统计学意义(均P>0.05)。结论采用腹腔热灌注化疗联合贝伐珠单抗治疗卵巢癌腹腔积液疗效显著,可降低VEGF水平,改善生活质量,且不良反应较少,安全性较高。

Objective To explore and analyze the effect and quality of life evaluation of intraperitoneal hyperthermic perfusion chemotherapy combined with bevacizumab in the treatment of ovarian cancer with peritoneal effusion. Methods From June 2013 to June 2015 in People＇s Hospital of Linqu County,80 cases of ovarian cancer patients with peritoneal effusion were selectd and divided into observation group and control group,40 cases in each group. Patients in two groups were given paclitaxel plus carboplatin systemic chemotherapy,while giving cisplatin in laparoscopic hot perfusion chemotherapy,with 6 weeks for a period of treatment,while patients in the observation group on the basis of this,were injected bevacizumab in each intraperitoneal hyperthermic perfusion chemotherapy,with 6 weeks for a period of treatment. The clinical efficacy,the level of vascular endothelial growth factor（ VEGF） in the treatment of ascites before and after treatment,the European Organzation for Research and Treatment of Cancer quality of life-C30（ EORTC QLQ-C30） and adverse reactions of the two groups were compared. Results Compared with the control group,the observation group of patients with a significant increase in efficiency and disease control rate,the difference was statistically significant（ P 〈0. 05）. Compared with before treatment,VEGF levels of patients in two groups after treatment were reduced. After treatment,the VEGF level of the observation group was significantly lower than that of the control group（ P 〈0. 05）. Compared with the control group,the patients in the observation group were significantly lower in the physical function,role function,cognitive function,emotional function,and community function score（ P 〈0. 05）. There was no significant difference in the incidence of fever,white blood cell reduction,nausea,vomiting,pain,fatigue,and weight loss in the two groups（ P 〉0. 05）. Conclusions The use of intraperitoneal hyperthermic perfusion chemotherapy combined with bevacizumab monoclonal antibody in the treatment of ovarian cancer with peritoneal effusion has a significant effect,can reduce VEGF level and improve the quality of life and with less adverse reactions,higher security.