热疗联合化疗在晚期卵巢癌合并腹腔积液患者中的应用价值

The application value of hyperthermia combined with chemothrapy in the treatment of advanced ovarian cancer with malignant ascites

目的探讨热疗联合化疗在晚期卵巢癌腹腔积液患者中的近期疗效及不良反应。方法收集2012年1月至2015年12月在江津区中心医院进行治疗的卵巢上皮癌合并腹腔积液的患者共102例进行回顾性研究。将102例患者分为局部热疗联合全身化疗组(试验组)45例和单纯全身化疗组(对照组)57例,均行紫杉醇联合顺铂/卡铂化疗。试验组在化疗基础上采用腹盆腔深部热疗,评价两组近期疗效及不良反应。结果试验组和对照组的有效率分别为71.1%和64.9%,差异无统计学意义(P=0.506);糖类蛋白125(CA125)下降至正常患者的比例分别为73.3%和59.6%,差异无统计学意义(P=0.148);2年生存率分别为51.1%和45.6%,差异无统计学意义(P=0.581)。生活质量总改善率为80.0%和61.40%,差异具有统计学意义(P=0.043);CA125半衰期分别为11.35和18.66d,差异具有统计学意义(P<0.001)。两组化疗的主要不良反应为骨髓抑制和胃肠反应,试验组与对照组发生Ⅲ~Ⅳ度骨髓抑制的比例为17.8%和15.8%,差异无统计学意义(P=0.789);发生Ⅲ~Ⅳ度胃肠反应24.4%和21.1%,差异无统计学意义(P=0.684)。结论热疗联合化疗能提高晚期卵巢癌合并腹腔积液患者的近期疗效,缓解患者因腹水引起的临床症状,提高生活质量,可在临床推广使用。

Objective To investigate the recent efficacy and toxicity of hyperthermia combined with systemic chemotherapy in advanced ovarian cancer with malignant ascites.Methods A total of 102 patients with advanced ovarian cancer were randomly assigned to the hyperthermia combined with systemic chemotherapy group（n=45）and the systemic chemotherapy group（n=57）.All patients in both of groups were treated with paclitaxel and cisplatin/carboplatin,and patients in the combined group were treated with abdominal and pelvic hyperthermia.The recent efficacy and toxicity in two groups were evaluated.Results The response rate of the two groups was 71.1% and 64.9%,difference was not statistically significant（P=0.506）.The proportion of patients with CA125 restored to normal was 73.3% and 59.6%,difference was not statistically significant（P=0.148）.The 2-year survival rate was 51.1% and 45.6%,difference was not statistically significant（P=0.581）,respectively.The improvement rate of life quality was 80.00%and 61.40% difference was statistically significant（P=0.043）.The half-life of CA125 was 11.35 dand 18.66 d,difference was statistically significant（P〈0.001）.The main toxicity were bone marrow suppression,gastrointestinal reaction.The proportion ofⅢto Ⅳdegree bone marrow suppression in the combined group and chemotherapy group were 17.8%and 15.8%（P=0.789）.The occurrence ofⅢtoⅣ gastrointestinal reaction were 24.4%and 21.1%（P=0.684）.Conclusion Hyperthermia combined with chemotherapy could improve the recent efficacy of advanced ovarian cancer with malignant ascites,and relieve the clinical symptoms caused by malignant ascites,improve the quality of life,and it is worthy of promotion.