腹腔热灌注化疗联合高频热疗治疗恶性腹水

目的:观察腹腔热灌注化疗联合热疗治疗恶性腹水的疗效及其副反应。方法:恶性腹水47例,随机分为治疗组及对照组。腹腔穿刺后连接负压引流器,引流干净腹水后,治疗组给予43-45℃的生理盐水500 ml+顺铂60 mg/m2、生理盐水1 000 ml+5-氟尿嘧啶500 mg/m2,快速灌注入腹腔,使进入腹腔的液体温度维持在42-44℃;灌注结束后,采用HG-2000型高频热疗机行腹腔热疗41-43℃,60 min,每周热疗2次;对照组给予生理盐水60ml+顺铂60 mg/m2、生理盐水100 ml+5-氟尿嘧啶500 mg/m2腹腔内注入。两组均于1 h内完成,每周灌注1次,连续灌注2周,评定疗效。结果:治疗组有效率65.2%,卡氏评分(KPS)升高率47.8%;对照组有效率45.8%,KPS升高率33.3%。治疗组腹水控制率、KPS升高率均较对照组明显为优(P<0.05)。两组副反应无明显差异。结论:腹腔热灌注化疗联合热疗治疗恶性腹水较单纯腹腔化疗疗效好,可以耐受。

Clinical Study of Chemotherapeutic Hyperthermic Intraperitoneal Perfusion Combined with High Freguency Hyperthermia for the Treatment of Malignant Ascites

Objective: To evaluate the effects and toxicities of the chemotherapeutic hyperthermic intraperitoneal perfusion(CHIP) combined with hyperthermia for the treatment of malignant ascites.Methods: Forty-seven cases of malignant ascites were randomly divided into treatment group and control group.Normal saline(NS,500 ml) + Cisplatin(60 mg/m2) and 1 000 ml NS + 5-FU 500 mg/m2 for two weeks at 43-45℃ were infused rapidly into abdominal cavity in an hour in treatment group after ascites were drained by peritoneocentesis,then the patients were treated with hyperthermia by external high frequency thermo-therapeutic apparatus HG-2 000(60 min,twice a week).Whereas 0.9% NS 60 ml + Cisplatin 60 mg/m2 and 0.9% NS 100 ml + 5-FU 500 mg/m2 were given in control group without heating.Results: KPS scale increasing rate was 47.8%(11/23) and the response rate of ascites was 65.2% in treatment group versus 33.3%(8/24) and 45.8% in control group respectively(both P<0.05),but the side-effects rate was the same and there were no grade 3 or 4 toxicity in the two groups.Conclusion: The chemotherapeutic hyperthermic intraperitoneal perfusion and hyperthermia was more efficient in the treatment for malignant ascites than the chemotherapy intraperitoneal without heating,while the toxicity and the side-effects were tolerable.