腹腔热灌注化疗治疗恶性腹水165例疗效及安全性分析.docVIP

精品论文 参考文献 腹腔热灌注化疗治疗恶性腹水165例疗效及安全性分析 姜溪 臧爱民（通讯作者）贾友超 赵琪 商琰红 杨华 胡玲 王志宇 　　河北大学附属医院肿瘤内科 河北保定 071000 　　摘要：目的：阐明腹腔热灌注化疗（HIPEC）治疗恶性腹水的方法，比较卵巢癌、胃癌和结直肠癌恶性腹水的临床疗效并对其进行分析，进一步探讨影响腹腔热灌注化疗疗效的相关因素。方法：以我科2008年12月至2013年12月收治的165例恶性腹水的患者为研究对象，对其临床资料进行分析。结果：KPS（行为状况评分）ge;60分的121例恶性腹水的患者，腹水有效率（RR）为64.46％，其中卵巢癌、胃癌和结直肠癌的腹水有效率分别为79.66%、54.29%和54.55%；KPS＜60分的44例患者HIPEC治疗后KPS评分较治疗前明显升高。治疗期间毒副反应均在正常耐受范围。同时进一步随访了161例患者，结果卵巢癌、胃癌和结直肠癌的中位生存时间（mOS）分别为18.5个月、12个月和10个月。其中卵巢癌HIPEC+全身化疗+减瘤术组较HIPEC+全身化疗组及单纯HIPEC组显示出了明显生存获益。结论：经HIPEC治疗后近期腹水量得到控制，化疗毒副反应没有明显增加，联合全身化疗进一步随访后有明显的生存改善，同时验证了腹腔热灌注温度和次数与治疗的疗效存在相关性。 　　关键词：恶性腹水；腹腔热灌注化疗；腹水有效率；生存率；中位生存时间 　　【Abstract】Objective：The purpose of this study was to clarily the methods of treating with malignant ascites by 　　HIPEC，compare and analyse its clinical effects on ovarian cancer，gastric cancer and colorectal cancer.To explore 　　The influence factors of HIPEC therapeutic effect.Methods：From December 2008 to December 2013，a total of 　　165 patients with malignant ascites were recruited to undergo HIPEC，and their clinical material was analysed.Results：Among 121 patients with malignant ascites，whose KPSge;60 points，their ascites response rate was 64.46%.Ascites response rate of ovarian cancer，gastric cancer and colorectal cancer was 79.66%、54.29%and54.55%.respectively.After a week of treatment，KPS raise significantly，compared with that of before（Plt;0.05）.At the same time，according to the mOS of ovarian cancer was 18.5 months，the mOS of gastric cancer and colorectal cancer was 14 months and 11 months.The ovarian cancer of HIPEC+chemotherapy+cytoreductive surgery group than HIPEC+ chemotherapy group and HIPEC group showed a significant survival benefit.Conclusion：In the short term，HIPEC can contol malignant ascites effectively.According to the follow up，we found that patients can benefit a lot in the long-term，and the toxic and side effect of HIPEC has not increase.Besides，we confirm that the temperature and frequency of HIPEC is related with its therapeutic e