持续循环腹腔热灌注化疗治疗肝胆胰恶性肿瘤的临床应用  

Clinical application of continuous hyperthermic peritoneal perfusion chemotherapy in hepatobiliary and pancreatic malignant tumors

作　　者：牟洪超[1] 崔书中[2] 

机构地区：[1]解放军第404医院肝胆外科,威海264200 [2]广州医科大学附属肿瘤医院,广州510095

出　　处：《消化肿瘤杂志（电子版）》2012年第4期223-227,共5页Journal of Digestive Oncology(Electronic Version)

摘　　要：目的探讨持续循环腹腔热灌注化疗(CHPPC)治疗肝胆胰恶性肿瘤的临床应用和技术方法。方法我科2011年4月至2012年8月收治的23例原发性肝癌患者、9例肝门部胆管癌患者和8例胰腺癌患者,其中根治术后31例和9例晚期恶性腹水患者行CHPPC治疗,观察灌注前后的反应和近期治疗效果。结果本组共40例,随访时间3～ 18个月,20例肝癌根治切除后患者中,1例巨大肝癌术后肝内复发,复发时间为术后8个月,1年累积复发率为8.0%;7例肝门部胆管癌术后有1例肝内转移复发,复发时间术后9个月;其余根治病例无肿瘤局部、腹腔、腹膜、膈肌、大网膜等转移。9例恶性腹水患者经腹腔热灌注化疗,7例腹水消失,2例腹水明显减少,症状缓解总有效率(RR)100%,其中2例已死亡,距灌注时间分别为6个月和10个月,最终无腹水出现,5例已存活6个月以上。CHPPC副作用包括4例出现恶心、呕吐,3例出现白细胞下降,无治疗相关并发症。结论持续循环腹腔热灌注化疗作为治疗肝胆胰恶性肿瘤一种方法,具有创伤小、安全、能有效预防术后复发,晚期患者恶性腹水控制好,有很好的应用前景。Objective To investigate the clinical application of continuous hyperthermic peritoneal perfusion chemotherapy(CHPPC) in hepatobiliary and pancreatic malignant tumors.Methods From April2011 to August 2012,.23 patients with primary hepatic cell carcinoma,.9 with hilar cholangiocarcinoma and 8 with pancreatic carcinoma received operation and CHPPC in our hospital..Adverse events and treatment efficacy for prevention of recurrence and control of malignant ascites were observed.Results 31patients after radical resection and 9 late-staged patients with malignant ascites received CHPPC.The adverse events included nausea and vomiting in 4 cases,leucopenia in 3 cases,and no CHPPC-related complications were found..After follow-up from 3 month to 18 months,.Among 20 HCC patients with radical resection,intrahepatic recurrence was found only in one case 8 months after operation,and 1-year cumulative recurrent rate was 8.0%..There was only one case with intrahepatic recurrence 9months after operation among 7 hilar cholangiocarcinoma cases with radical resection..Ascites disappeared in 7 cases and remarkably decreased in 2 cases among 9 cases with malignant ascites.The total response rate of CHPPC for malignant ascites was 100%,and 5 cases survived more than 6months so far.Conclusion As a new therapeutic approach for hepatobiliary and pancreatic malignant tumors,CHPPC is safe and effective for prevention of postoperative recurrence and control of malignant ascites with application prospect.

关 键 词：腹腔热灌注 化疗 恶性腹水 肝胆胰恶性肿瘤 

分 类 号：R735[医药卫生—肿瘤]