热疗联合TC化疗治疗晚期卵巢癌的疗效及对免疫逃逸、远期预后的影响

Effect of thermotherapy combined with TC chemotherapy on advanced ovarian cancer and the impact on immune escape and long-term prognosis

目的探讨热疗联合TC化疗治疗晚期卵巢癌的疗效,评估该治疗方案对患者免疫逃逸、远期预后的影响。方法选取2012年8月至2015年7月间枣阳市第一人民医院诊治的98例晚期卵巢癌患者作为研究对象。回顾性分析治疗方案并分为对照组(n=50,接受TC化疗)、研究组(n=48,接受热疗联合TC化疗),均持续6疗程。评估两组患者治疗6疗程后的近期疗效及免疫逃逸指标水平,治疗后随访3年并记录生存率、生存时间。结果治疗6个疗程后,研究组患者的有效率、疾病控制率均高于对照组患者,差异具有统计学意义(P<0.05);外周血中Treg的水平低于对照组患者,TIDC、NK的水平高于对照组患者,差异具有统计学意义(P<0.05)。随访3年内,研究组患者的1年、2年、3年生存率均高于对照组患者,无进展生存时间及总生存时间长于对照组患者,差异具有统计学意义(P<0.05)。结论晚期卵巢癌患者在TC静脉化疗基础上加入腹腔热疗,可进一步提升近期疗效并减轻肿瘤免疫逃逸,且有助于优化患者的远期预后。

Objective To study the efficacy of thermotherapy combined with TC chemotherapy in patients with advanced ovarian cancer,and evaluate their influence on the immune escape and long-term prognosis.Methods 98 patients with advanced ovarian cancer in First People′s Hospital of Zaoyang during August 2012 to July 2015 were chosen as research subject.The treatment schemes were retrospectively analyzed and all the patients were divided into control group(n=50,TC chemotherapy)and study group(n=48,thermotherapy combined with TC chemotherapy),both for 6 courses.Short-term efficacy and immune escape indexes of the two groups were evaluated after 6 courses of treatment and the survival rate and survival time were recorded within 3-year follow-up.Results After 6 courses of treatment,the effective rate and disease control rate in study group were higher than those in control group,with statistically significant differences(P<0.05).The levels of Treg in peripheral blood in study group was lower than that in control group,and levels of TIDC and NK were higher than those in control group,with statistically significant differences(P<0.05).The 1-year,2-year and 3-year survival rates in study group were higher than those in control group,and the progression-free survival time and total survival time in study group were longer than those in control group,with statistically significant differences(P<0.05).Conclusions Intraperitoneal thermotherapy combined with TC intravenous chemotherapy can further improve the short-term efficacy and reduce tumor immune escape,which is conductive to optimizing the long-term prognosis of patients with advanced ovarian cancer.