腹腔恩度加化疗联合局部热疗治疗恶性腹腔积液的临床观察

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),分为治疗组(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组腹腔还加用恩度,比较两组临床近期疗效、生活质量及毒副反应。结果:A组总有效率为76%,B组为57.1%,两组近期疗效差异显著,有统计学意义(P<0.05)。A、B两组生活质量(QOL)改善率分别为72%和60.7%,两组差异无统计学意义(P>0.05);A组主要不良反应为Ⅰ～Ⅱ级的胃肠道反应,恶心呕吐占44%(11/25),腹痛12%(3/25),腹泻4%(1/25);Ⅰ～Ⅱ级粒细胞减少16%(4/25),Ⅲ级粒细胞减少4%(1/25)。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深入研究。

The clinical observation of abdominal endostar plus chemotherapy and local hyperthermia treatment of malignant ascites

Objective: To observe the efficacy and safety of effusion infusion Endostar combined with the chemotherapy and hyperthermia on advanced cancer with malignant ascites.Methods: 53 advanced cancer patients with malignant ascites confirmed by histopathology or cytopathology.All the patients were divided into A and B groups.Both groups were been given chemotherapy DDP 40～60mg and hyperthermia.Otherwise,A group combined with Endostar 60mg D1,4.All patients were given hyperthermia twice a week D1,4.The regimen was repeated every 7 days.The efficacy was evaluated after 2 cycles according to WHO criteria,and quality of life(QOL) was evaluated according to karnofsky scores.Results:53 cases were capable of safety evaluation.The effective rate of A group was 76%,while 57.1% of the B group.The quality of life(QOL)of A group was improved on 18 cases(72%),while 17 cases of the B group(60.7%).All the patients were of good tolerance as a whole and no severe side effects happened.Conclusion: Intraperitoneal Endostatin combined with DDP and local hyperthermia results in a good response rate and improvement of QOL for the patients with malignant ascites.The combined regimen was low toxic and tolerable.The regimen is worthy of further clinical observation.