益肾抗瘤方联合IL-2腹腔灌注治疗卵巢癌相关腹水的疗效观察

Effects of Yishen Kangliu recipe in combination with IL-2 peritoneal perfusion in treatment of ovarian cancer-associated ascites

目的:探讨益肾抗瘤方联合白细胞介素-2(IL-2)腹腔灌注治疗卵巢癌相关腹水的疗效。方法:采用随机数字表法将98例卵巢癌相关腹水患者分为试验组49例与对照组49例,两组均给予紫杉醇联合卡铂化疗。在此基础上,对照组给予IL-2腹腔灌注治疗,试验组IL-2腹腔灌注联合益肾抗瘤方治疗。观察并比较两组患者的腹水控制有效率、癌胚抗原(CEA)、糖类抗原125(CA125)、人附睾蛋白4(HE4)、血管内皮生长因子(VEGF)、T淋巴细胞亚群变化、免疫球蛋白(Ig) A、Ig M、Ig G水平变化、不良反应及Karnofsky评分变化情况。比较两组的无进展生存期(PFS)。结果:试验组腹水控制总有效率显著高于对照组(P <0. 05)。试验组的CA125总缓解率及控制率分别为71. 4%、95. 9%,均显著高于对照组的46. 9%、83. 7%(P <0. 05)。治疗后,试验组CEA、CA125、HE4及VEGF水平显著低于治疗前及对照组治疗后(P <0. 05)。试验组患者CD3+、CD4+、CD4+/CD8+、NK细胞及IgM、IgG水平显著高于治疗前和对照组(P <0. 05)。试验组胃肠道反应、白细胞下降、血小板降低、转氨酶升高、尿素氮升高及周围神经症状的发生率显著低于对照组(P <0. 05)。试验组的PFS为6. 0(3～12)个月,显著长于对照组的4. 0 (2～10)个月(χ2=8. 113,P <0. 01)。结论:益肾抗瘤方联合IL-2腹腔灌注治疗卵巢癌并发恶性腹水疗效确切,可有效抑制肿瘤细胞的增殖,改善患者生存质量,安全性较高,值得推广。

AIM:To investigate the therapeutic effect of Yishen Kangliu recipe combined with IL-2 peritoneal perfusion on advanced ovarian cancer-related ascites.METHODS:Ninety-eight cases of ovarian cancer-related ascites were divided into experimental group(49 cases)and control group(49 cases)by random number table.Both groups were treated with paclitaxel combined with carboplatin.On the basis of this,the control group was given intraperitoneal infusion of IL-2,while the experimental group IL-2 intraperitoneal perfusion combined with Yishen Kangliu receipe treatment.The effective rate of ascites control,CEA,CA125,HE4,VEGF,T lymphocyte subsets,IgA,IgM,IgG level changes,adverse reactions and Karnofsky score changes,and PFS of the groups were compared.RESULTS:The total effective rate of the experimental group was significantly higher than that of the control group(P<0.05).The total remission rate and control rate of CA125 in the experimental group were 71.4%and 95.9%respectively,which were significantly higher than 46.9%and 83.7%in the control group(P<0.05).After treatment,the levels of CEA,CA125,HE4 and VEGF in the experimental group were significantly lower than those before treatment and after the control group(P<0.05).After treatment,the levels of CD3+,CD4+,CD4+/CD8+,NK cells and IgM,IgG in the experimental group were significantly higher than those before treatment,and the experimental group was significantly higher than the control group(P<0.05).Gastrointestinal reactions,leukopenia,thrombocytopenia,elevated transaminases,elevated urea nitrogen and peripheral neurological symptoms in the experimental group were significantly lower than those in the control group(P<0.05).PFS in the experimental group was 6.0(3-12)months,which was significantly longer than that in the control group 4.0(2-10)months(χ^2=8.113,P<0.01).CONCLUSION:Yishen Kangliu recipe combined with IL-2 intraperitoneal perfusion in the treatment of ovarian cancer complicated with malignant ascites i can effectively inhibit the proliferation of tumor cells and improve the quality of life of patients with high safety.