腹腔热灌注化疗辅助治疗结直肠癌合并恶性腹腔积液的疗效及安全性

Effect and safety of adjuvant hyperthermic intraperitoneal chemotherapy in the treatment of colorectal cancer complicated with malignant ascites

目的探讨腹腔热灌注化疗辅助治疗结直肠癌合并恶性腹腔积液的疗效及安全性。方法根据治疗方式的不同将102例结直肠癌合并恶性腹腔积液患者分为单纯化疗组和综合治疗组,每组51例,单纯化疗组患者采用常规化疗,综合治疗组患者在单纯化疗组的基础上采用腹腔热灌注化疗。比较两组患者的临床疗效、肿瘤标志物水平、生活质量[欧洲癌症研究与治疗组织生命质量测定量表(EORTC QLQ-C30)]及不良反应发生情况。结果综合治疗组患者的总缓解率和疾病控制率均高于单纯化疗组(P<0.05)。治疗后,两组患者的血清癌胚抗原和糖类抗原19-9水平均低于本组治疗前,综合治疗组患者的血清癌胚抗原和糖类抗原19-9水平均低于单纯化疗组,差异均有统计学意义(P<0.05)。治疗后,两组患者躯体功能、社会功能、情绪功能、角色功能、认知功能评分均高于本组治疗前,综合治疗组患者躯体功能、社会功能、情绪功能、角色功能、认知功能评分均高于单纯化疗组,差异均有统计学意义(P<0.05)。综合治疗组患者的不良反应总发生率明显低于单纯化疗组(P<0.01)。结论对结直肠癌合并恶性腹腔积液患者采用腹腔热灌注化疗辅助治疗可有效降低肿瘤标志物水平,提高生活质量,且安全性较高,疗效确切。

Objective To investigate the efficacy and safety of adjuvant hyperthermic intraperitoneal chemotherapy in the treatment of colorectal cancer complicated with malignant ascites.Method A total of 102 patients with colorectal cancer complicated with malignant ascites were divided into simple chemotherapy group and comprehensive treatment group according to different treatment methods,with 51 cases in each group.The patients in the single chemotherapy group received conventional chemotherapy,and the patients in the comprehensive treatment group received hyperthermic intraperitoneal chemotherapy on the basis of the single chemotherapy group.The clinical efficacy,tumor marker levels,quality of life[European Organization for Research and Treatment of Cancer quality of life questionnaire core 30(EORTC QLQ-C30)],and adverse events were compared between the two groups.Result The total response rate and disease control rate of the comprehensive treatment group were higher than those in the single chemotherapy group(P<0.05).After the treatment,the serum carcinoembryonic antigen and carbohydrate antigen 19-9 levels in the two groups were lower than those before the treatment,and the serum carcinoembryonic antigen and carbohydrate antigen 19-9 levels in the comprehensive treatment group were lower than those in the single chemotherapy group,and the differences were statistically significant(P<0.05).After the treatment,the scores of physical function,social function,emotional function,role function,and cognitive function in the two groups were higher than those before the treatment,and these scores in the comprehensive treatment group were significantly higher than those in the single chemotherapy group,and the differences were statistically significant(P<0.05).The total incidence of adverse events in the comprehensive treatment group was significantly lower than that in the single chemotherapy group(P<0.01).Conclusion The adjuvant therapy of hyperthermic intraperitoneal chemotherapy for colorectal cancer patients complicated with malignant ascites could effectively reduce the levels of tumor markers.This regimen can improve the quality of life of patients,and has high safety with definite curative effect.