多西他赛和顺铂联合全身热疗治疗晚期胃癌并发腹腔积液的疗效观察

Efficacy of docetaxel and cisplatin combined with systemic hyperthermia for advanced gastric cancer complicated with seroperitoneum

目的探讨多西他赛和顺铂联合全身热疗治疗晚期胃癌并发腹腔积液的临床效果。方法选取2013年2月至2015年5月间辽宁省阜新市第二人民医院(阜新市妇产医院)收治的140例晚期胃癌并发腹腔积液患者,采用随机数字表法分为观察组与对照组,每组70例。观察组患者在多西他赛与顺铂热灌注治疗基础上加用全身热疗,对照组患者给予多西他赛与顺铂热灌注治疗,比较两组患者治疗前后生活质量评分(KPS)、腹水控制情况、疾病控制率及不良反应发生情况。结果治疗后,观察组患者KPS评分改善比例为75.7%,明显高于对照组的54.3%,两组比较差异有统计学意义(P<0.05);观察组患者腹水控制情况总有效率为94.3%,明显高于对照组的82.9%,差异有统计学意义(P<0.05);观察组患者疾病控制率为68.6%,对照组患者疾病控制率为48.6%,两组比较差异有统计学意义(P<0.05);两组患者不良反应均以恶心、呕吐、腹泻、血小板减少、脱发及手足综合征为主,观察组患者Ⅲ~Ⅳ级不良反应发生率明显低于对照组患者,差异有统计学意义(P<0.05)。结论多西他赛和顺铂联合全身热疗治疗晚期胃癌并发腹腔积液临床效果显著,明显控制腹水进展,提升疾病控制率,改善患者生活质量,不良反应发生率低,值得临床推广。

Objective To study the clinical efficacy of docetaxel and cisplatin combined with systemic hyperthermia in the treatment of advanced gastric cancer complicated with seroperitoneum.Methods Select 140 patients with advanced gastric cancer complicated with seroperitoneum treated at The Second People＇s Hospital of Fuxin City from February 2013 to May 2015.They were randomly divided into an observation group and a control group with 70 patients in each group.Patients in the control received hyperthermal perfusion of docetaxel and cisplatin.Apart from the above treatment,patients in the observation group were treated with the systemic hyperthermia.The improvement of the quality of life（Karnofsky performance status,KPS） score,ascites control,disease control and adverse reactions were compared between the two groups before and after treatment Results Improvement rate of KPS score was 75.7% for the observation group which was significantly higher than 54.3% of the control group（P〈0.05）.For the ascites,the overall efficacy rate was 94.3% for the observation group which was higher than 82.9% of the control group（P〈0.05）.For the disease control rate was 68.6% for the observation group and 48.6% for the control group（P〈0.05）.The mainly adverse effect was nausea,vomiting,diarrhea,thrombocytopenia,alopecia and hand-foot syndrome.The incidence of grade Ⅲ-Ⅳ adverse reactions in the observation group was significantly lower than in the control group（P〈0.05）.Conclusion Docetaxel and cisplatin combined with systemic hyperthermia has high efficacy in the treatment of advanced gastric cancer complicated with seroperitoneum.The progress of ascites was significantly controlled.Quality of life was significantly improved,with fewer adverse reaction,which was worthy of clinical promotion.