腹腔热灌注化疗在卵巢癌术后的应用探讨  

Application of chemohyperthermia peritoneal perfusion for ovary cancer patients after surgery

作　　者：徐萍萍[1] 

机构地区：[1]中国人民解放军第八一医院妇产科,江苏南京210002

出　　处：《现代肿瘤医学》2007年第6期839-841,共3页Journal of Modern Oncology

摘　　要：目的:探讨卵巢癌术后腹腔热灌注化疗的可行性、安全性及短期疗效。方法:对2002年7月至2005年12月收治的25例卵巢癌,术中均行根治或姑息性切除;对直径≥0.5cm的腹腔内转移灶用电刀减量戮灭。术后第1d开始,每日腹腔热灌注化疗1次,每次60～90min,一般4次为1疗程,共计做98次。结果:循环通畅率96.9%(62/64),治疗时间内腹腔内温度82%达到41℃以上,各出水管温度均超过41℃,并保持60～90min。并发症及毒副反应有:轻度腹腔感染2例,腹痛4例,恶心呕吐2例,转氨酶轻度升高1例。随访6～27个月,术后每3个月复查1次B超或CT,腹腔转移3例,腹腔转移率为18.8%,1例术后6个月死于全身广泛转移,另1例术后13个月死于腹腔转移及肝转移。最长1例随访时间为29个月,现仍存活。结论:术后早期腹腔热灌注化疗安全,腹腔内温度较均匀,可多次进行,并发症少且毒副反应小,有利于卵巢癌术后腹腔内较小的残余癌或游离癌细胞的杀灭。Objective： To evaluate the feasibility, safety and short -term efficacy of chemohyperthermic peritoneal perfusion （CHPP） by monitoring the progress of patients following the resection of ovary carcinoma. Methods： From July 2002 to December 2005,25 patients with ovary carcinoma performed radical dissection or palliative resection and intraperitoneal metastases in diameter of 〉 0.5cm were reduced using electrical knife. Several perfusion tubes entering and exiting the peritoneal cavity were maintained after closing the abdomen. The patients underwent CHPP immediately on postoperative day 1. The hyperthermic perfusion was maintained for 60 - 90 min per day. Typically one treatment cycle was repeated 4 times,98 times treatment were made. Results： Circulation was sufficiently fluent for treatment in approximately 96.9% （62/64） of patients. The mean intraperitoneal temperature during perfusion was maintained above 41℃ in 82% of patients. Mean perfusate temperature was maintained above 41 ℃ for 60 - 90min. Complications included minor intraperitoneal infections in 2 patients, abdominal pain in 4 patients, nausea and vomiting in 2 patients, transaminase concentration marginally higher in 1 patient. Follow up survey of 6 - 27 months and ultrasonography or computerized tomography were carried every 3 months and showed intraperitoneal metastasis in 3 （ 18.8% ） patients. One patient died from broad metastasis in 6 months and one from intraperitoneal and liver metastasis in 13 months. One patient still lives in 29 months. Conclusion： CHPP is safe and beneficial to eliminating small remained cancer or dissociative cancer cells in the patients following curative resection of ovary carcinomas.

关 键 词：妇科肿瘤 腹腔 热灌注化疗 

分 类 号：R737.31[医药卫生—肿瘤]