恩度加化疗联合局部热疗治疗恶性腹腔积液临床观察

目的观察腹腔灌注重组人血管内皮抑制素注射液(恩度)加化疗联合局部热疗治疗恶性腹腔积液的近期疗效和安全性。方法经病理组织学或细胞学检查确诊的恶性腹腔积液患者53例(胃癌31例、结肠癌10例、直肠癌12例),分治疗组(A)25例和对照组(B)28例,A、B两组腹腔均灌注化疗联合局部热疗;A组腹腔加用恩度,比较两组临床近期疗效、生活质量及不良反应。结果 A组总有效率为76.0%,B组为57.1%,两组近期疗效差异有统计学意义(P<0.05)。A、B两组行为状态评分(KPS)改善率分别为72.0%和57.1%,两组比较差异有统计学意义(P<0.05);临床症状改善明显而治疗相关不良反应不明显。结论腹腔恩度加用化疗联合局部热疗治疗恶性腹腔积液近期疗效显著且安全,能提高患者的生活质量,值得临床上推广应用和进一步研究。

Clinical observation on effect of intraperitoneal Endostar combined with chemotherapy and local hyperthermia on malignant ascites

Objective To evaluate the efficiency and safety of Endostar combined with chemotherapy and local hyperthermia on malignant ascites.Methods Fifty-three advanced cancer patients with malignant ascites were confirmed by histopathology or cytopathology.All the patients were divided into the treatment group（25 cases,Group A） and the control group（28 cases,Group B）.Both groups were given chemotherapy（DDP 40~60 mg） and local hyperthermia.Meanwhile the patients in Group A were treated with Endostar 60 mg d1,d4.All the patients were given local hyperthermia twice a week（d1,d4）.The regimen was repeated every 7 days.The effect was evaluated after 2 cycles according to RESICT criteria,and Karnofsky scores was evaluated.Results The total effective rate of Group A was 76.0%,while that of Group B was 57.1%.The total efficiency was significantly different（P0.05）.Karnofsky scores of Group A was improved in 18 cases（72.0%）,and 16 cases of Group B（57.1%）.The total efficiency was significantly different（P0.05）.For Group A,the occurrence rate of toxicities was low,which was mainly related with the chemotherapy agents.The regimen was well tolerable and generally did not give rise to serious side effects.Conclusions Intraperitoneal Endostatin combined with DDP and local hyperthermia results in a good response rate and improves Karnofsky scores in the patients with malignant ascites.The combined regimen was low toxic and tolerable.The regimen is worthy of clinic application and further research.