腹腔热灌注化疗治疗腹部恶性肿瘤的近期疗效及毒副反应分析  

Short-term efficacy and adverse events of intraperitoneal hyperthermic perfusion chemotherapy in abdominal malignant tumors

作　　者：张少锐[1] 区小卫[1] 黄文[1] 刘世强[1] 廖冠群[1] 

机构地区：[1]南方医科大学附属佛山医院普外一区,佛山528000

出　　处：《消化肿瘤杂志（电子版）》2012年第4期228-231,共4页Journal of Digestive Oncology(Electronic Version)

摘　　要：目的观察腹腔热灌注化疗(intraperitoneal hyperthermic perfusion chemotherapy,IHPC)治疗腹部恶性肿瘤的近期疗效和毒副反应。方法对37例胃肠癌手术患者和7例恶性腹水患者使用BR-TRG-Ⅱ型体腔热灌注治疗系统进行IHPC,观察患者的生命体征、实验室及影像学结果,评估其近期疗效和毒副反应。结果44例患者顺利完成治疗。7例恶性腹水患者中5例腹水患者完全缓解,2例部分缓解,有效率为100%;患者生存质量卡氏功能状态评分治疗前为(57.14±7.56),治疗后上升为(80.00±11.55),差异有统计学意义(P=0.001)。治疗后血压偏低、脉搏偏快、高热发生率分别为6.8%、20.5%、6.8%,低蛋白、低钠血症的发生率为68.2%和18.2%。化疗药物引起Ⅰ/Ⅱ度骨髓抑制、消化道反应和肾毒性的发生率分别为8.8%、23.5%、2.9%,少见Ⅲ/Ⅳ度毒副反应。10例姑息切除胃肠癌患者的中位生存期13.2个月,1年生存率达56%。结论 IHPC是消除恶性腹水、改善患者生活质量的有效治疗手段,IHPC后毒副反应小,根治术后患者有望能预防腹膜种植复发,改善预后。Objective To observe the efficacy and adverse events of intraperitoneal hyperthermic perfusion chemotherapy(IHPC) in abdominal malignant tumors.Methods From June 2011 to September 2012,thirty-seven patients after gastrointestinal cancer surgery and 7 cases with malignant ascites received IHPC in our hospital.The clinical data including vital signs,laboratory and imaging results of these patients were analyzed to evaluate the short-term efficacy and adverse events of IHPC.Results IHPC was successfully completed in all the patients.Complete or partial response was observed in all 7 cases with malignant ascites with a total effective rate of 100%,and the mean score of Karnofsky performance status increased from(57.14±7.56) to(80.00±11.55) after IHPC(P=0.001).The incidences of hypotension,tachyrhythmia,fever,hypoalbuminemia and hyponatremia were 6.8%,20.5%,6.8%,68.2% and 18.2% respectively.The incidences of Ⅰ / Ⅱ degree adverse events of IHPC were 8.8% for bone marrow suppression,23.5% for gastrointestinal reaction and 2.9% for renal toxicity,while there were less Ⅲ / Ⅳ degree adverse events.The median survival of the 10 patients undogoing IHPC after palliative resection was 13.2 months,with 1-year survival rate of 56%.Conclusions IHPC is an effective treatment method for malignant ascites and can improve the quality of life of such patients.Its application is expected to prevent postoperative peritoneal recurrence and improve prognosis after radical resection in gastrointestinal carcinoma.

关 键 词：腹部肿瘤 恶性腹水 腹腔热灌注化疗 毒副反应 

分 类 号：R730.5[医药卫生—肿瘤]