子宫内膜癌根治术联合腹腔热灌注化疗治疗子宫内膜癌的疗效及预后分析

Analysis of efficacy and prognosis of radical resection combined with hyperthermic intraperitoneal chemotherapy in the treatment of endometrial cancer

目的研究子宫内膜癌根治术联合腹腔热灌注化疗治疗子宫内膜癌的疗效及预后分析。方法院2018年1月-2020年12月间收治的60例行根治术治疗的子宫内膜癌患者纳为研究对象,根据患者意愿,采用不同的术后辅助治疗方式,其中33例患者术后一周内行腹腔热灌注化疗(观察组);其余27例患者未行腹腔热灌注化疗,予以辅助静脉化疗(对照组),比较两组治疗效果及预后。结果两组手术时间、术中出血量、淋巴结清扫个数及术后并发症均无显著性差异(P>0.05);观察组化疗有效率显著高于对照组(P<0.05);两组骨髓抑制、肝功能受损、肾功能受损、周围神经损伤、心血管病变等毒副作用发生情况无显著性差异(P>0.05),观察组肠道反应较对照组严重,差异有显著性意义(P<0.05);观察组随访时间为6~35个月,3年内复发例数11例(局部转移4例,远处转移7例),无瘤存活者18例,失访4例。对照组随访时间6~34个月,3年复发例数17例(局部复发3例,远处转移14例),无瘤存活者5例,失访者5例。绘制生存曲线发现,观察组与对照组PFS差异显著(Rank X^(2)=11.681,P<0.05)。结论子宫内膜癌根治术联合腹腔热灌注化疗能有效提高子宫内膜癌治疗效果,减少癌灶术后转移,提高患者疾病无进展生存时间。

Objective To investigate the efficacy and prognosis of radical resection combined with hyperthermic intraperitoneal chemotherapy(HIPEC)in the treatment of endometrial cancer.Methods Sixty patients with endometrial cancer who underwent radical mastectomy who were admitted between January 2018 and December 2020 were included in the study.According to the wishes of the patients,different postoperative adjuvant treatment methods were adopted,of which 33 patients were one week after surgery Intraperitoneal hyperthermic perfusion chemotherapy(observation group)was performed;the remaining 27 patients did not receive intraperitoneal hyperthermic perfusion chemotherapy,but received adjuvant intravenous chemotherapy(control group).The treatment effects and prognosis of the two groups were compared.Results The operation time,intraoperative blood loss,number of lymph node dissection and postoperative complications showed no significant difference between groups(P>0.05).The effective rate of chemotherapy in observation group was significantly higher than that in control group(P<0.05).There was no significant difference in the occurrence of toxic and side effects such as bone marrow suppression,liver function damage,renal function damage,peripheral nerve injury and cardiovascular disease between groups(P>0.05).Intestinal reaction in observation group was more serious than that in control group(P<0.05).The observation group was followed up for 6 to 35 months.There were 11 cases of recurrence within 3 years(4 cases of local metastasis,7 cases of distant metastasis),18 cases of tumor-free survivors,and 4 cases lost to follow-up.The control group was followed up for 6 to 34 months,with 17 cases of recurrence in 3 years(3 cases of local recurrence,14 cases of distant metastasis),5 cases of tumor-free survivors,and 5 cases of lost to follow-up.The survival curve was drawn and it was found that there was a significant difference in PFS between the observation group and the control group(Rank X^(2)=11.681,P<0.05).Conclusion Radical resection of endometrial cancer combined with intraperitoneal hyperthermic perfusion chemotherapy can effectively improve the treatment effect of endometrial cancer,reduce postoperative metastasis of cancer,and improve the patient’s disease-free survival time.