高精度持续循环腹腔热灌注化疗对上皮性卵巢癌术后患者的疗效分析

Influence of high-precision continuous cyclic intraoperative peritoneal hyperthermic chemotherapy on the prognosis of patients with epithelial ovarian cancer

目的探讨高精度持续循环腹腔热灌注化疗(IPHC)对上皮性卵巢癌患者手术预后的影响。方法根据术后不同化疗方式将笔者所在医院2015年1月—2018年3月收治的85例上皮性卵巢癌患者分为观察组与对照组,分别采取高精度持续循环IPHC联合静脉化疗与单纯静脉化疗。21 d为1周期,均干预6周期。评价疗效、生存质量改善、不良反应及预后情况,治疗前、治疗6个周期后测定两组患者细胞免疫功能指标。结果观察组术后3个月CA125控制率为88.89%,显著高于对照组的65.00%(P<0.05);观察组治疗后CD3+、CD4+、CD4+/CD8+均显著大于同组治疗前、对照组治疗后,CD8+显著低于治疗前、对照组治疗后,差异均有统计学意义(P<0.05);对照组治疗前后细胞免疫功能指标比较差异无统计学意义(P>0.05);观察组生存质量改善显著优于对照组(P<0.05);两组不良反应比较差异无统计学意义(P>0.05);观察组3年生存率75.55%,显著高于对照组的50.00%(P<0.05)。结论相比单纯静脉化疗,加以高精度持续循环IPHC能明显改善上皮性卵巢癌患者的免疫功能,提高其生存质量及3年生存率,不良反应少。

Objective To explore the influence of high-precision continuous cyclic intraoperative peritoneal hyperthermic chemotherapy(IPHC)on the prognosis of patients with epithelial ovarian cancer.Methods According to different postoperative chemotherapy methods,the 85 patients with epithelial ovarian cancer admitted to authors'hospital from January 2015 to March 2018 were divided into observation group and control group.The two groups were treated with high-precision continuous cyclic IPHC combined with intravenous chemotherapy and simple intravenous chemotherapy,respectively,for 21 days as a cycle;they were intervened for 6 cycles.The efficacy,quality of life improvement,toxic and side adverses and prognosis were evaluated.The cellular immune function indexes of the two groups were measured before treatment and after 6 cycles of treatment.Results The control rate of CA125 in observation group at 3 months after operation was significantly higher than that in control group[88.89%vs 65.00%,(P<0.05)].The levels of CD3+,CD4+and CD4+/CD8+in observation group after treatment were significantly higher than those before treatment and those in control group after treatment,and the CD8+level was significantly lower than that before treatment and that in control group after treatment(P<0.05).There were no significant differences in the cellular immune function indexes in control group before and after treatment(P>0.05).The quality of life improvement in observation group was significantly better than that in control group(P<0.05).There were no significant differences in the toxic and side effects between the two groups(P>0.05).The 3-year survival rate in observation group was significantly higher than that in control group(75.55%vs 50.00%)(P<0.05).Conclusion Compared with simple intravenous chemotherapy,the additional use of high-precision continuous-cycle IPHC can significantly improve the immune function of patients with epithelial ovarian cancer,and promote the quality of life and 3-year survival rate,and it has few adverse reactions.