腹腔热灌注化疗联合rhIL-2序贯疗法治疗恶性腹腔积液的近期疗效观察

Short-term Efficacy of Peritoneal Thermal Perfusion Chemotherapy Combined with rhIL-2 Sequential Therapy in the Treatment of Malignant Peritoneal Effusion

目的评价腹腔热灌注化疗联合rhIL-2序贯疗法治疗恶性腹腔积液的近期疗效,分析疗效差异原因。方法收集2012年6月-2017年6月湖南省肿瘤医院收治的72例恶性腹腔积液患者的完整临床资料,随机分为序贯治疗组和对照组。序贯治疗组38例,采用氟尿嘧啶+顺铂腹腔热灌注化疗联合序贯腹腔灌注rhIL-2;对照组34例,采用氟尿嘧啶+顺铂腹腔热灌注化疗。分析并比较两组患者的腹水缓解率及化疗不良反应。结果对照组有效率为41.2%,腹水中位缓解时间为7.4个月,序贯治疗组有效率为73.7%,腹水中位缓解时间为11.3个月,两组比较,差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论相比单纯腹腔热灌注化疗,腹腔热灌注化疗联合rhIL-2序贯治疗可在局部达到更好的控制效果,且未增加不良反应,患者耐受性好,可用于恶性腹腔积液患者的姑息治疗。

Objective To evaluate the short-term efficacy of peritoneal thermal perfusion chemotherapy combined with rhIL-2 sequential therapy in the treatment of malignant peritoneal effusion and analyze the reason of difference of curative effect.Methods Between June 2012 and June 2017,72 patients with malignant peritoneal effusion were admitted in Hunan Cancer Hospital.Their complete clinical data were collected.Patients were randomly divided into sequential therapy group and control group.In the sequential therapy group,38 patients were treated with fluorouracil + cisplatin peritoneal thermal perfusion chemotherapy combined with sequential peritoneal infusion of rhIL-2.In the control group,34 patients were treated with single fluorouracil + cisplatinum peritoneal thermal perfusion chemotherapy.The ascites remission rate and adverse reactions of chemotherapy were analyzed and compared.Results The effective rate of the control group was 41.2%,and that of the sequential therapy group was 73.7%.The mean ascites remission time was 11.3 months in the sequential therapy group but was 7.4 months in the control group.The differences between the two groups were statistically significant(P<0.05).There was no significant difference in adverse reactions between the two groups(P>0.05).Conclusions The peritoneal heat perfusion chemotherapy combined with rhIL-2 can achieve better local control effect as compared with simple peritoneal heat perfusion chemotherapy.The patient has good tolerance and no increase in adverse reactions.This combination therapy can be used for palliative treatment of patients with malignant peritoneal effusion.