卵巢癌惡性腹腔積液TP方案靜脈聯(lián)合循環(huán)熱灌注化療臨床療效分析
發(fā)布時間：2018-11-12 16:19
【摘要】：目的惡性腹腔積液(malignant peritoneal ascites,MPE)是嚴(yán)重威脅晚期卵巢癌患者生存質(zhì)量、生存時間的并發(fā)癥之一。比較采用紫杉醇和順鉑靜脈聯(lián)合腹腔循環(huán)熱灌注化療與單純腹腔灌注化療治療晚期卵巢癌合并惡性腹腔積液的臨床療效。方法將2008-04-2013-07開封市中心醫(yī)院收住的68例晚期卵巢癌術(shù)后復(fù)發(fā)或無法行手術(shù)治療(合并其他遠處轉(zhuǎn)移無法手術(shù)、或因心肺等基礎(chǔ)疾病無法手術(shù)、或患者、家屬拒絕手術(shù)者)、合并惡性腹腔積液的患者。按照隨機原則分為觀察組和對照組,每組各34例。觀察組采用紫杉醇聯(lián)合順鉑腹腔循環(huán)熱灌注化療,對照組采用紫杉醇聯(lián)合順鉑單純腹腔灌注化療。比較兩組臨床療效、生活質(zhì)量、免疫功能指標(biāo)、不良反應(yīng)和生存率等。結(jié)果觀察組和對照組客觀緩解率分別為85.29%和58.82%,差異有統(tǒng)計學(xué)意義,χ~2=5.916 2,P0.05;應(yīng)用SF-12生活量表評價,觀察組患者在總體健康(t=3.498 6,P0.05)、精神健康(t=3.642 6,P0.05)和情感職能(t=17.523 2,P0.001)方面評分均高于對照組,差異有統(tǒng)計學(xué)意義;CD4和CD4/CD8水平,觀察組治療后高于治療前(t=4.086 9,P0.05;t=2.647 9,P0.05),并高于對照組治療后(t=4.279 1,P0.05;t=3.214 6,P0.05),差異有統(tǒng)計學(xué)意義;對照組治療前后各免疫功能指標(biāo)水平比較,差異均無統(tǒng)計學(xué)意義,P0.05;觀察組和對照組不良反應(yīng)發(fā)生率分別為44.05%和47.00%,差異無統(tǒng)計學(xué)意義,χ~2=0.059 3,P0.05;治療組與對照組相比,1、2和3年生存率均顯示優(yōu)勢,但差異無統(tǒng)計學(xué)意義。結(jié)論紫杉醇靜脈聯(lián)合腹腔順鉑循環(huán)熱灌注化療治療晚期卵巢癌療效顯著,毒副作用小,生存質(zhì)量無明顯下降,總體健康、精神健康、情感職能均有升高,有生存期優(yōu)勢,值得臨床推廣應(yīng)用。
[Abstract]:Objective malignant peritoneal effusion (malignant peritoneal ascites,MPE) is a serious threat to the quality of life and survival time of patients with advanced ovarian cancer complications. To compare the clinical efficacy of paclitaxel and cisplatin combined with intraperitoneal circulatory hyperthermic chemotherapy and intraperitoneal infusion chemotherapy in the treatment of advanced ovarian cancer with malignant peritoneal effusion. Methods Sixty-eight patients with advanced ovarian cancer who were admitted to Kaifeng Central Hospital from April 2008 to July 2013-07 were treated with recurrence or failure to undergo surgical treatment (complicated with other distant metastases or unable to operate due to basic diseases such as cardiopulmonary disease, etc.) Patients with malignant peritoneal effusion. According to the random principle, they were divided into observation group and control group with 34 cases in each group. The observation group was treated with paclitaxel combined with cisplatin intraperitoneal circulation chemotherapy and the control group with paclitaxel combined with cisplatin intraperitoneal infusion chemotherapy. The clinical efficacy, quality of life, immune function index, adverse reaction and survival rate were compared between the two groups. Results the objective remission rates of the observation group and the control group were 85.29% and 58.82%, respectively. The difference was statistically significant (蠂 ~ 2 ~ (5.916 2) P 0.05). Using SF-12 life scale, the scores of overall health (t = 3.498-6P 0.05), mental health (t n = 3.642 6) and affective function (t = 17.523 2n P0.001) in the observation group were higher than those in the control group, and the scores of the patients in the observation group were higher than those in the control group (P < 0.05). The difference was statistically significant. The levels of CD4 and CD4/CD8 in the observation group after treatment were higher than those before treatment (t = 4.0869, P 0.05, P = 2.647, P 0.05), and higher than those in the control group, respectively (P < 0.05, P < 0.05). The difference was statistically significant. In the control group, there was no significant difference in the level of immune function before and after treatment (P0.05). The incidence of adverse reactions in the observation group and the control group was 44.05% and 47.00%, respectively. The 1-2 and 3-year survival rates in the treatment group were superior to those in the control group, but the difference was not statistically significant. Conclusion the efficacy of paclitaxel combined with intraperitoneal Cisplatin circulation perfusion chemotherapy in the treatment of advanced ovarian cancer is significant, with little side effect, no significant decline in quality of life, general health, mental health and emotional function, and has the advantage of survival period. It is worth popularizing and applying in clinic.
【作者單位】： 開封市中心醫(yī)院腫瘤診療中心;
【基金】：開封市科技攻關(guān)計劃(HO.130324)
【分類號】：R737.31
本文編號：2327573
[Abstract]:Objective malignant peritoneal effusion (malignant peritoneal ascites,MPE) is a serious threat to the quality of life and survival time of patients with advanced ovarian cancer complications. To compare the clinical efficacy of paclitaxel and cisplatin combined with intraperitoneal circulatory hyperthermic chemotherapy and intraperitoneal infusion chemotherapy in the treatment of advanced ovarian cancer with malignant peritoneal effusion. Methods Sixty-eight patients with advanced ovarian cancer who were admitted to Kaifeng Central Hospital from April 2008 to July 2013-07 were treated with recurrence or failure to undergo surgical treatment (complicated with other distant metastases or unable to operate due to basic diseases such as cardiopulmonary disease, etc.) Patients with malignant peritoneal effusion. According to the random principle, they were divided into observation group and control group with 34 cases in each group. The observation group was treated with paclitaxel combined with cisplatin intraperitoneal circulation chemotherapy and the control group with paclitaxel combined with cisplatin intraperitoneal infusion chemotherapy. The clinical efficacy, quality of life, immune function index, adverse reaction and survival rate were compared between the two groups. Results the objective remission rates of the observation group and the control group were 85.29% and 58.82%, respectively. The difference was statistically significant (蠂 ~ 2 ~ (5.916 2) P 0.05). Using SF-12 life scale, the scores of overall health (t = 3.498-6P 0.05), mental health (t n = 3.642 6) and affective function (t = 17.523 2n P0.001) in the observation group were higher than those in the control group, and the scores of the patients in the observation group were higher than those in the control group (P < 0.05). The difference was statistically significant. The levels of CD4 and CD4/CD8 in the observation group after treatment were higher than those before treatment (t = 4.0869, P 0.05, P = 2.647, P 0.05), and higher than those in the control group, respectively (P < 0.05, P < 0.05). The difference was statistically significant. In the control group, there was no significant difference in the level of immune function before and after treatment (P0.05). The incidence of adverse reactions in the observation group and the control group was 44.05% and 47.00%, respectively. The 1-2 and 3-year survival rates in the treatment group were superior to those in the control group, but the difference was not statistically significant. Conclusion the efficacy of paclitaxel combined with intraperitoneal Cisplatin circulation perfusion chemotherapy in the treatment of advanced ovarian cancer is significant, with little side effect, no significant decline in quality of life, general health, mental health and emotional function, and has the advantage of survival period. It is worth popularizing and applying in clinic.
【作者單位】： 開封市中心醫(yī)院腫瘤診療中心;
【基金】：開封市科技攻關(guān)計劃(HO.130324)
【分類號】：R737.31
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