腹腔热灌注疗法对上皮性卵巢癌腹腔转移患者治疗效果的影响

The effect of hyperthermic intraperitoneal chemoperfusion for the patients with peritoneal metastasis of epithelial ovarian cancer

目的探究腹腔热灌注疗法对上皮性卵巢癌腹腔转移患者治疗效果的影响。方法回顾性分析164例上皮性卵巢癌腹腔转移患者的临床资料。根据治疗方法不同,分为观察组(紫杉醇+顺铂腹腔热灌注联合静脉化疗)82例和对照组(紫杉醇+顺铂常规静脉化疗)82例。比较两组患者糖类抗原125(CA125)、血清人附睾分泌蛋白4(HE4)水平及白细胞(WBC)计数、不良反应的发生情况、腹腔积液缓解率、生活质量(QLQ)评分及随访36个月的无进展生存时间。结果治疗前,两组患者的CA125水平、HE4水平、WBC计数、QLQ评分比较,差异均无统计学意义(P﹥0.05);治疗后,观察组患者的CA125、HE4水平分别为(63.38±7.39)U/ml、(53.31±5.93)pmol/L,均明显低于对照组的(68.53±8.51)U/ml、(56.04±5.28)pmol/L,差异均有统计学意义(P﹤0.01);治疗后,观察组患者的WBC计数为(4.13±1.02)×109/L,明显高于对照组的(3.61±1.15)×109/L,差异有统计学意义(P﹤0.01)。治疗过程中,观察组患者的肾功能不全、骨髓抑制、听力异常的发生率均低于对照组,差异均有统计学意义(P﹤0.05);治疗后,观察组患者的腹腔积液缓解率、QLQ评分均明显高于对照组,差异均有统计学意义(P﹤0.01);治疗后,观察组患者的无进展生存时间明显长于对照组,差异有统计学意义(P﹤0.01)。结论与常规静脉化疗比较,腹腔热灌注疗法可降低化疗药物引起的不良反应发生率,提高腹腔积液缓解率及患者的生活质量,延长患者无进展生存时间,建议临床推广应用。

Objective To explore the effect of hyerpthermic intraperitoneal chemoperfusion for the patients with peritoneal metastasis of epithelial ovarian cancer.Method The clinical data of 164 cases with epithelial ovarian cancer and peritoneal metastasis were retrospectively investigated,who were grouped by different treatment administered as study group(paclitaxel+cisplatin by hyerpthermic intraperitoneal chemoperfusion combined with intravenous chemotherapy)and control group(paclitaxel+cisplatin),with 82 cases in each.The two groups were compared in regard of levels of carbohydrate antigen 125(CA125),human epididymal secretory protein 4(HE4),white blood cell(WBC)count,adverse reactions,remission rate of ascites,quality of life questionnaire(QLQ)score and progression-free survival time after following up for 36 months.Result There was no significantly difference between the two groups regarding the CA125,HE4,WBC,and QLQ before treatment(P>0.05);after treatment,the levels of CA125 and HE4 in study group were(63.38±7.39)U/ml and(53.31±5.93)pmol/L,and were significantly lower than those in the control group at(68.53±8.51)U/ml and(56.04±5.28)pmol/L,respectively(P<0.01);the post-treatment WBC count was(4.13±1.02)×10^9/L in study group,which was significantly higher than that of the control group at(3.61±1.15)×10^9/L(P<0.01);the incidence of renal insufficiency,bone marrow supression and abnormal hearing were lower in study group than in control group during the course of treatment,showing statistically significant difference(P<0.05);after treatment,the remission rate of ascites,QLQ score increased significantly in study group compared with control group(P<0.01),and so did the progression-free survival time,and the differences were of statistical significance(P<0.01).Conclusion Compared with conventional intravenous chemotherapy,hyerpthermic intraperitoneal chemoperfusion may further reduce the incidence of chemotherapy-induced adverse reactions,improving the remission rate of ascites and quality of life,prolonging the progression-free survival time for patients.