静脉化疗联合高精度持续循环腹腔热灌注化疗治疗卵巢癌的疗效观察

Therapeutic effects of intravenous chemotherapy combined with high-precision continuous intraperitoneal hyperthermic perfusion chemotherapy on ovarian cancer

目的探讨静脉化疗联合高精度持续循环腹腔热灌注化疗较全身静脉化疗治疗卵巢癌的疗效。方法选取住院治疗的卵巢癌减灭术术后患者80例,随机分为2组,对照组采取常规全身静脉化疗,观察组在对照组基础上联合高精度持续循环腹腔热灌注化疗,比较2组患者治疗后CA125、CA199、腹水的变化,不良反应情况,肿瘤控制情况,治疗后前两年的生存率及平均生存率的差异。结果观察组治疗后1个月、3个月CA125、CA199水平降至正常例数均高于对照组(P<0.05),治疗后1个月、3个月,观察组腹水控制率均高于对照组(P<0.05)。治疗后2组均有不良反应发生,分别为:肝肾功能损害、胃肠道反应、白细胞减少、心律失常,其中在白细胞减少、心律失常的比较中,观察组较对照组发生率更低(P<0.05)。治疗后观察组总有效率为75.0%显著高于对照组的52.5%(P<0.05)。观察组患者治疗后第1年、第2年生存率及平均生存率显著优于对照组(P<0.05),观察组平均生存率为(17.9±3.2)个月,高于对照组平均生存率(14.1±2.8)个月,差异有统计学意义(P<0.05)。结论采取持续循环腹腔热灌注化疗联合静脉化疗治疗卵巢癌患者,有助于患者控制腹水,不良反应少,肿瘤控制率高,生存期更长,其疗效显著优于全身静脉化疗,值得进一步推广。

Objective To compare the therapeutic effects of intravenous chemotherapy combined with high-precision continuous intraperitoneal hyperthermic perfusion chemotherapy and systemic intravenous chemotherapy on ovarian cancer.Methods Eighty patients with ovarian cancer who were admitted and treated in our hospital from February 2015 to February 2016 were randomly divided into two groups.The patients in control group were treated by routine systemic intravenous chemotherapy,however,the patients in observation group,on the basis of control group,were treated by high-precision continuous intraperitoneal hyperthermic perfusion chemotherapy.After treatment the levels of CA125,CA199,and ascites,adverse reactions,tumor control status,the survical rate on two years after treatment and average survival rate were observed and compared between two groups.Results The levels of CA125 and CA199 on 3m,6m after treatment in observation group were significantly higher than those in control group(P<0.05),moreover,the control rate of ascites in observation group was also significantly higher than that in control group(P<0.05).After treatment,the adverse reactions including liver and kidney damage,gastrointestinal reactions,leukopenia,arrhythmia were found in both groups,however,the incidence rates of leukopenia,arrhythmia in observation group were significantly lower than those in control group(P<0.05).Moreover the total effective rate in observation group was 75.0%,which was significantly higher than that(52.5%)in control group(P<0.05).The average survival rate in observation group was(17.9±3.2)months,which was significantly higher than that(14.1±2.8)months in control group(P<0.05).Conclusion The continuous intraperitoneal hyperthermic perfusion chemotherapy combined with intravenous chemotherapy in treatment of ovarian cancer is beneficial to control ascites,with fewer adverse reactions,higher tumor control rate,longer survival time,moreover,its therapeutic effects are superior to those by systemic intravenous chemotherapy,therefor,which is worth using widely in clinical practice.