体外药物敏感性试验指导下腹腔化疗的研究

目的 探讨体外药敏试验指导下对晚期肿瘤进行腹腔化疗的可行性及效果。方法 分离51例恶性肿瘤患者腹水中的肿瘤细胞,MTT法测定肿瘤细胞对化疗药物的敏感性,选择对肿瘤细胞抑制率最高或次高的一种化疗药物进行腹腔化疗,观察药敏结果与癌性腹水疗效的一致性,及其与临床病例特征、KPS评分和预后的关系。结果 MTT法显示TXT和HCPT是最敏感的化疗药物,而HCPT用于腹腔化疗最多（56．9％）。全组共有24例患者癌性腹水治疗有效（CR7例,PR17例）,药敏结果与癌性腹水疗效之间存在低度一致性（P=0．014）,癌性腹水有效组的行为状态评分（KPS）改善程度明显优于无效组（P〈0．001）。癌性腹水治疗是否有效,系本组患者的独立预后因素（P=0．035）。结论 MTT法药敏试验指导下腹腔化疗是一种简便、有效、安全的方法,癌性腹水治疗有效者的KPS及预后可明显改善。

In vitro chemo-sensitivity MTT assay guided intraperitoneal chemotherapy for malignant ascites

OBJECTIVE: To evaluate the feasibility and efficacy of intraperitoneal chemotherapy for malignant ascites caused by different types of abdominal cancers guided by chemo-sensitivity methyl tetrojolium coloremetric (MTT) assay in vitro. METHODS: Cancer cells in the malignant ascites were collected for MTT assay to determine the chemo-sensitivity. The drug producing the highest or the second highest inhibition rate was selected for intraperitoneal chemotherapy. The correlation between the results of MTT assay and the response of malignant ascites, the clinical features, Karnofsky performance score (KPS) and prognosis were analyzed. RESULTS: MTT assay indicated that Taxotere (TXT) and Hydroxycamptothecin (HCPT) were the most effective to cancer cells in malignant ascites, and HCPT was mostly frequently used for intraperitoneal chemotherapy (56.9%). Twenty-four patients showed response by intraperitoneal chemotherapy (complete response: 7; partial response: 17) with a slightly significant correlation between the results of MTT assay and response of malignant ascites (P = 0. 014). The KPS of the responders was improved significantly (P < 0.001), and the response of malignant ascites to intraperitoneal chemotherapy was demostrated as an independent prognostic factor by multi-variate analysis in this series. CONCLUSION: In vitro chemo-sensitivity MTT assay guided intraperitoneal chemotherapy for malignant ascites is simple, effective and safe, which can improve the KPS and prognosis of the responders.