重组人血管内皮抑制素联合全身化疗治疗晚期胃癌腹腔积液的临床观察

目的观察重组人血管内皮抑制素（恩度）联合化疗治疗晚期胃癌恶性腹腔积液的近期疗效，评价恩度局部应用的安全性和耐受性。方法对23例伴有恶性腹腔积液的晚期胃癌患者，应用恩度腹腔灌注给药，尽可能抽出腹腔内积液，注入恩度60rag，每周1次，连续3周。全身化疗静脉滴注奥沙利铂，按130mg／m^2计算给药，替吉奥80mg／（m^2·d），分早晚2次餐后口服，连用14d，每3周为1周期。评价近期疗效、生活质量以及毒副反应。结果所有患者均可进行客观疗效评价及安全性评价，均完成2周期以上治疗，腹水控制有效率65％，其中5例完全缓解（CR），10例部分缓解（PR），5例稳定（sD），3例进展（PD），疾病控制率（DCR）为87％，生活质量改善患者有20例，占87％。药物相关性毒副反应不明显。结论恩度腹腔灌注给药能较好地控制恶性腹水，减轻临床症状，改善患者生活质量，安全性较好，不增加化疗药物的毒性。

Clinical observation of the recombinant human endostatin combined with chemotherapy in the treatment of advanced gastric cancer with malignant ascites

Objective To observe the curative effect of the recombinant human endostatin（en- dostar） combined with chemotherapy in the treatment of advanced gastric cancer with malignant ascites, and to evaluate the safety and efficacy of the endostar. Methods Endostar thoracic cavity perfusion was applied in 23 cases of patients with advanced gastric cancer with malignant ascites. Following amaximum release of thoracic cavity fluid, endostar 60 miligrame alongwith 100mL sa- line could be injected in, once time a week, 3 weeks were a cycle. L-OHP calculated on the basis of 130mg/m2 was given by intravenous infusion, S-1 was given according to 80mg/（m2 ~ d）, morning and evening oral after meal, with 14 consecutive days, and every three weeks was one cycle. Recent efficacy, quality of life, as well as toxicity were evaluated. Results Twenty-three cases of patients could be given an objective evaluation of the efficacy and safety, all patients could complete 2 cycles treatment. Ascites efficient control rate was 65%, 5 cases of CR, 10 ca- ses of PR, 5 cases of SD, 3 cases of PD. Disease control rate（DCR） was 87%; the whole group 20 cases of patients were found to improve their quality of life, accounting for 87%. Conclusion Endostar thoracic cavity infusion can better control the malignant ascites to reduce the clinical symptoms. Endostar in combination with the chemotherapy drug may play a joint role to improve the life quality of patients. Clinical safety is better, with no accumulated adverse reactions.