重组人血管内皮抑制素联合顺铂腹腔热灌注化疗对肝胆胰恶性肿瘤腹腔积液的疗效观察

Therapeutic effect of recombinant human endostatin combined with cisplatin hyperthermic intraperitoneal chemotherapy on peritoneal effusion of hepatobiliary and pancreatic malignancies

目的探讨对肝胆胰恶性肿瘤腹腔积液患者采用重组人血管内皮抑制素联合顺铂腹腔热灌注化疗(hyperthermic intraperitoneal chemotherapy, HIPEC)的效果和安全性。方法将70例肝胆胰恶性肿瘤腹腔积液患者分成对照组和观察组,对照组给予顺铂行HIPEC,观察组加用重组人血管内皮抑制素行HIPEC;观察两组的肿瘤、细胞免疫和肝功能指标的变化,以及疗效和化疗毒副反应。结果 3周后两组的AFP、CEA、CA125和CD8;水平低于治疗前,CD4;和CD4;/CD8;水平升高,观察组的改善幅度高于对照组(P<0.05)。两组的ALT和TBA水平低于治疗前,ALB和Fg水平升高(P<0.05);组间差异无统计学意义(P>0.05)。观察组的ORR和DCR高于对照组(P<0.05);毒副反应率组间差异无统计学意义(P>0.05)。结论对肝胆胰恶性肿瘤腹腔积液患者采用重组人血管内皮抑制素联合顺铂行HIPEC,能控制肿瘤发展,提高细胞免疫功能,改善肝功能和疾病预后,安全性较高。

Objective To investigate the efficacy and safety of recombinant human endostatin combined with cisplatin hyperthermic intraperitoneal chemotherapy(HIPEC) in patients with peritoneal effusion of hepatobiliary and pancreatic malignancies.Methods 70 patients with intraperitoneal effusion of hepatobiliary and pancreatic malignancies were divided into two groups. The control group was given cisplatin for HIPEC, and the observation group was given HIPEC with recombinant human endostatin. The changes of tumor, cellular immunity and liver function indexes, as well as the curative effect and chemotherapy toxicity were observed.Results After 3 weeks, the levels of AFP, CEA, CA125 and CD8;in the two groups were lower than those before treatment, and the levels of CD4;and CD4;/CD8;were higher in the observation group than those in the control group(P<0.05). ALT and TBA levels in the two groups were lower than those before treatment, ALB and Fg levels were increased(P<0.05). There was no significant difference between groups(P>0.05). ORR and DCR in the observation group were higher than those in the control group(P<0.05). There was no significant difference in the rate of toxic and side effects between groups(P>0.05). Conclusion The combination of recombinant human endostatin and cisplatin for HIPEC in patients with peritoneal effusion of hepatobiliary and pancreatic malignancies can control tumor development, improve cellular immune function, improve liver function and disease prognosis, with high safety.