恩度联合多西他赛序贯腹腔灌注治疗胃癌伴恶性腹水的临床观察

Clinical observation of endostar combined with docetaxel sequential intraperitoneal perfusion in the treatment of gastric carcinoma with malignant ascites

目的:回顾性分析恩度联合多西他赛序贯腹腔灌注治疗胃癌伴恶性腹水的疗效及不良反应。方法:收集72例胃癌伴腹水患者,曾接受过二线及以上方案化疗,观察组35例,采用恩度45 mg联合多西他赛35 mg/m2 d1,d5序贯腹腔灌注1周期;对照组37例,采用多西他赛35 mg/m2 d1,d5腹腔灌注1周期,统计患者腹水控制有效率、KPS改善率、腹水控制时间及不良反应。结果:治疗组中腹水控制有效率71.43%;对照组中腹水控制有效率48.65%,P=0.049,两组具有统计学差异;治疗组中KPS改善率77.14%,对照组中KPS改善率54. 05%,P=0. 04,两组具有统计学差异;观察组中腹水控制时间8~90天,中位控制时间44天,对照组中腹水控制时间5~66天,中位控制时间28天,两组控制时间比较,P=0. 048,具有统计学差异;Ⅲ级以上不良反应发生率低,无治疗相关性死亡,两组不良反应比较,P> 0. 05,无统计学差异。结论:恩度联合多西他赛序贯腹腔灌注治疗体力状况(performance status,PS)评分较差的胃癌伴恶性腹水患者,腹水控制较好,能明显提高患者生活质量,未见明显不良反应。

Objective:To retrospectively analyse the efficacy and adverse effects of endostar combined with docetaxel sequential intraperitoneal perfusion in the treatment of gastric carcinoma with malignant ascites.Methods:72 cases of gastric cancer patients with ascites had received second-line chemotherapy and above.The observation group(35 cases) was trcated with 45 mg of endostar combined with docetaxel(Calculated according to 35 mg/m2 d1,d5) sequential intraperitoneal perfusion after 1 cycles.The control group(37 cases) was treated with docetaxel(Calculated according to 35 mg/m2 d1,d5) intraperitoneal perfusion for 1 cycle.The effective probability of control of ascites,the probability of Improvement in quality of life,the control time of ascites and the adverse reactions were recored.Results:The effective rate of ascites control was 71.43% in the observation group and 48.65% in the control group.There was a statistical difference between the two groups(P=0.049).The improvement rate of KPS was 77.14% in the observation group and 54.05% in the control group.There was a statistical difference between the two groups(P=0.04).The control time of ascites in the observation group was 8~90 days,and the median control time was 44 days.In the control group,the control time of ascites was 5~66 days and the median control time was 28 days.The control time of the two groups was significantly different(P=0.048).The incidence of adverse reactions above Ⅲ was low,no treatment-related deaths,and there was no statistical difference between the two groups of adverse reactions,P>0.05.Conclusion:For the poor PS score of gastric cancer patients with malignant ascites,endostar combined with docetaxel sequential intraperitoneal therapy is a good treatment.It can control ascites well and obviously improve the quality of life with no obvious adverse reactions.This scheme is safe and effective and is worthy of further promotion in clinical practice.