榄香烯乳联合洛铂腹腔热灌注治疗中晚期结直肠癌恶性腹水的临床研究

Clinical study ofβ-elemene combined with lobaplatin hyperthermic introperitoneal chemotherapy for middle and advanced colorectal cancer with malignant ascites

目的探讨榄香烯乳联合化疗药物洛铂腹腔热灌注对中晚期恶性结直肠癌腹水的临床疗效。方法对2017年1月至2019年12月,广州医科大学附属肿瘤医院诊断为中晚期大肠癌并伴恶性腹水的患者共40例,按照入组条件,遵循抛硬币法分为治疗组(20例),对照组(20例),对照组予单药洛铂(50 mg),治疗组予洛铂(50 mg)加中药榄香烯乳(400 mg/m 2)行腹腔热灌注治疗。对两组治疗前后4周的疗效进行比较。采用WHO腹水治疗疗效评估标准,比较两组的客观缓解率,用Karnofsky(KPS)体能评分标准对病人的体能改善进行评价,并对病人消化道不良反应发生率进行评价。结果40例患者全部完成治疗。治疗组的客观缓解率为80%,显著高于对照组的40%(P<0.05)。化疗后4周,治疗组的KPS评分、白细胞、血红蛋白、血小板均显著优于对照组(P<0.05)。组内比较,治疗组血红蛋白化疗前后的变化有统计学差异,对照组白细胞、血小板、血红蛋白化疗前后均有统计学差异。结论中药榄香烯联合洛铂腹腔热灌注可明显改善腹水病人的体力状况,减轻单用化疗药物热灌注的毒副作用,疗效优于单用洛铂,消化道不良反应发生率低。

Objective In this study,we aimed to analyze the clinical effects ofβ-elemene emulsion combined with Lobaplatin(LBP)for middle and advanced colorectal cancer with malignant ascites.Methods From January 2017 to December 2019,In total,40 patients were diagnosed with middle and advanced colorectal cancer with malignant ascites in our hospital.According to the conditions,the patients were divided into treatment group(20 cases),control group(20 cases),The control group was given single LBP(50 mg),and the treatment group was given LBP(50 mg)plusβ-elemene emulsion(400 mg/m 2).Comparison of efficacy before treatment and 4 weeks after treatment,Standard WHO Ascitic Effusion Evaluation were used.Objective response rate(ORR)were compared between the two groups.According to Karnofsky Performance Scale(KPS)Score grading system,physical fitness will be evaluated.The incidence of adverse reactions of the gastrointestinal were observed.Data were statistically analyzed using SPSS ver.ORR,KPS and the incidence of adverse reactions of the gastrointestinal were used to evaluate the short-term efficacy of the patients.Results All 40 patients completed treatment.The ORR of the control group was 40%,and the treatment group was 80%.P<0.05 indicates a statistically significant difference between two groups.After 4 weeks,the KPS was significantly higher in the treatment groups compared with the control group.The statistics are shown within group comparisons,there was a statistical differences between the treatment group and the control group.In the treatment groups,hemoglobin(Hb)has a statistically significant difference pre-and post-chemotherapy,on the other hand,in the control group,the white blood cells(WBC),Hb and platelets(PLA)have a statistically significant difference pre-and post-chemotherapy.Conclusion Theβ-elemene combined with LBP hyperthermic introperitoneal chemotherapy(HIPEC)for middle and advanced colorectal cancer with malignant ascites can obviously improve the physical strength of patients,reduce the toxic and side effects of intraperitoneal hyperthermic perfusion of chemotherapeutic drugs alone.The incidence of digestive tract adverse reaction is low.