腹腔热灌注联合全身静脉化疗在卵巢癌治疗中的不良反应评价

Adverse Reaction of HIPEC Combined with Intravenous Chemotherapy on Ovarian Cancer Patients

目的评价肿瘤细胞减灭术后行腹腔热灌注联合全身静脉化疗在卵巢癌治疗中的不良反应及其对患者生存期的影响。方法选取163例卵巢癌患者作为研究对象,所有患者均行肿瘤细胞减灭术并按照治疗方法分为观察组(47例)与对照组(116例),观察组为术后行腹腔热灌注联合全身静脉化疗,对照组为术后单纯全身静脉化疗。观察两组患者的不良反应发生情况,并对所有患者进行术后随访。结果观察组低蛋白血症发生率高于对照组,而白细胞减少、血小板下降、腹胀及腹痛发生率低于对照组(P<0.05),其余不良反应差异无统计学意义。当患者热灌注次数>2次时D2聚体升高、低钙血症、血糖升高和恶心呕吐的发生率升高(P<0.05)。两组患者总生存率无显著差异,观察组无贫血或轻度贫血患者生存情况优于重度贫血患者(P<0.05),其余不良反应的发生对患者整体生存率没有显著影响。结论卵巢肿瘤细胞减灭术后行腹腔热灌注化疗联合静脉化疗并不会增加不良反应、尤其是严重不良反应的发生,但存在低蛋白血症发生率高的特点。

Objective To evaluate adverse reactions of the hyperthermic intraperitoneal chemotherapy(HIPEC)combined with intravenous chemotherapy in the treatment of ovarian cancer(OC)after the cytoreductive surgery(CRS),and to analyse the effect of adverse reactions on the survival time of patients.Methods We selected 163 patients with ovarian cancer.All patients got CRS for OC,and then were divided into two groups according to the different treatment modes:observation group(n=47,HIPEC in combination of intravenous chemotherapy)and control group(n=116,intravenous chemotherapy).The adverse reactions of the two groups were observed.All patients were followed up after operation.Results The incidence of hypoproteinemia in the observation group was higher than that in the control group,while the incidence of leukopenia,thrombocytopenia,abdominal distention and abdominal pain were lower than those in the control group(P<0.05),and the other adverse reactions were not statistically different.The incidence of D-Dimer increase,hypocalcemia,hyperglycemia as well as nausea and vomiting in patients with>2 cycles of HIPEC were increased(P<0.05).There was no significant difference in overall survival rate between the two groups.The survival of patients without anemia or mild anemia in the observation group was better than that of patients with severe anemia(P<0.05).The occurrence of other adverse reactions had no significant effect on the overall survival rate of the patients.Conclusion HIPEC combined with intravenous chemotherapy after CRS would not increase adverse reactions,especially severe adverse reactions in OC patients,but there is a high incidence of hypoproteinemia.