冷冻联合光动力和腔内灌注化疗对恶性间皮瘤的疗效分析

目的探讨冷冻联合光动力和腔内灌注化疗对恶性间皮瘤患者的疗效。方法对2003年9月至2012年6月广州复大医院收治的27例Ⅳ期恶性间皮瘤患者进行回顾性分析。全部患者治疗前都接受过化疗,化疗失败后来我院寻求进一步治疗。18例接受冷冻外科联合光动力和腔内化疗的患者为综合治疗组,9例只接受腔内灌注化疗的患者为姑息治疗组,评价两组患者的生存期差异,及治疗时机选择和治疗次数对患者生存期的影响。结果综合治疗组患者(中位生存64个月)的总体生存期显著长于姑息治疗组(中位生存9个月,P<0.001)。无论是综合治疗(多次治疗患者中位生存81.5个月,单次治疗患者中位生存38个月,P=0.0403)还是姑息治疗(多次治疗患者中位生存26.5个月,单次治疗患者中位生存7个月,P=0.037),多次治疗患者的生存期显著长于单次治疗。结论冷冻联合光动力和腔内灌注化疗可明显延长恶性间皮瘤患者全身化疗失败后的生存时间,多次治疗后患者生存时间可进一步延长。

Effects of cryosurgery, photodynamic therapy and intracavity chemotherapy for the treatment of malignant mesothelima

Objective To investigate multiple minimally invasive combination therapy （cryosurgery, photodynamie therapy and intracavity chemotherapy ） for the treatment of malignant mesothelioma patients in whom systemic chemotherapy had failed. Methods It was studied that of patients treated for malignant pleura] mesotheliona（MPM）or diffuse malignant pleura] mesotheliona（DMPM） in our cancer hospital from September 2003 to June 2012. 27 patients were divided into comprehensive （combination of the three therapies, 18 cases） and palliative （intraeavity ehemotherapy only, 9 cases） treatment groups. The interval survival for two group patients were assessed during a follow-up period. Result The overall survival of patients who received comprehensive treatment was significantly longer than that of those who received palliative treatment （ median overall survival： 64 vs. 9 months, P 〈 0. 001 ） and repeated treatments also prolonged the overall survival of patients than one time treatment, whatever comprehensive treatment （median overall survival： 81.5 vs. 38 months, P = 0. 0403 ） and palliative treatment （ median overall survival ： 26.5 vs. 7 months, P = 0. 037 ）. Conclusion Comprehensive treatments may have an advantage over palliative treatments for malignant mesothelioma patients in whom systemic chemotherapy had failed.