射频热疗结合腹腔热灌注化疗治疗晚期卵巢癌近期疗效观察.docVIP

射频热疗结合腹腔热灌注化疗治疗晚期卵巢癌近期疗效观察 　 作者：沈湘，严兆华，余忠华，许丽华 【关键词】 卵巢癌；腹腔温热化疗；预后 　　摘要：目的：评估射频热疗结合腹腔热灌注化疗对晚期卵巢癌的治疗效果，以探讨治疗方法。方法：将46例晚期卵巢癌患者随机分为射频热疗结合腹腔热灌注化疗组（热化疗组）24例和腹腔常温灌注化疗组（化疗组）22例。全部病人均行常规腹腔穿刺，无腹水者穿刺成功后直接灌注，有腹水者先引流干净腹水再行灌注。热化疗组注入已预热到45℃的生理盐水+顺铂并立即用SR-1000射频热疗机进行热疗，维持腹腔内温度在40.5～43℃、70～90min；每周热灌注化疗1次，单纯热疗1次；共治疗2～3周。化疗组注入常温下的生理盐水+顺铂，每周1次，共治疗2～3次。观察患者治疗后疼痛症状改变、腹水控制情况及生活质量等，对比两组的治疗效果。结果：两组的腹水控制率、疼痛的缓解率、生活质量改善率分别为：热化疗组65%，71.4%，66.7%；化疗组25%，30.8%，27.3%。两组间各项指标均有显著差异，而两组间的化疗毒副作用无明显差别，热化疗组出现3例脂肪硬结。结论：腹腔热灌注化疗结合射频热疗治疗晚期卵巢癌的效果优于单纯腹腔化疗，值得临床推广应用。 　　关键词：卵巢癌；腹腔温热化疗；预后 　　The Effect of Intraperitoneal Chemohyperthermia(IPHC) with SR-1000 Radiofrequency on Advanced Ovarian Cancer 　　Abstract：Objective：To study the efficacy of intraperitoneal chemohyperthermia with SR-1000 Radiofrequency on advanced ovarian cancer. Method：46 patients with advanced ovarian cancer were randomly divided into two groups ①IPHC groups, 24 cases, were infused hot NS and DDP in abdominal cavity, and maintained the temperature of abdominal cavity at 40.5～43℃ for 70～90 minutes with SR-1000 RF. Hyperthermia was given twice per week and chemotherapy once per week with the whole treatment lasting for 2～3 weeks; ②Intraperitoneal normal-thermo-chemotherapy(IPNC) group, 22 cases, were infused normal temperature NS and DDP in abdominal cavity once per week, lasting for 2～3 weeks. Pain, ascites and lived quality of patients were observed. Result：The two groups have differences in pain relief, ascites reduced and lived quality improved, IPHC group: 65%，71.4%，66.7%；IPNC group: 25%，30.8%，27.3%. They have no differences in side effects. Conclusion： Intraperitoneal chemohyperthermia with SR-1000 RF is more effectual than intraperitoneal normal-thermo-chemotherapy for advanced ovarian cancer. 　　Key words：Ovarian cancer；Intraperitoneal hyperthermo-chemotherapy（IHPC）；Prognosis 　　卵巢癌是严重威胁妇女健康的常见肿瘤。在我国，女性生殖道恶性肿瘤中，卵巢癌的发病率位居第三位，而其死亡率为女性恶性肿瘤之首［1］。由于卵巢深居盆腔，约2/3卵巢癌患者出现症状时已是晚期，尽管相当一部份患者经过手术治疗及全身化疗和腹腔化疗，但绝大多数患者仍失败于盆腹腔内复发或转移。由于这些患者多数已经历多程化疗，失去了进