亚砷酸循环腹腔热灌注治疗胃癌恶性腹水的临床观察  

Clinical observation of peritoneal hyperthermic perfusion of arsenious acid in treatment of malignant ascites of gastric cancer

作　　者：邓运宗[1] 郭寒冰[1] 黄兴[1] 康斐[1] 王媛媛[1] 董旭辉[1] 贾润霞[1] 王红玲[1] DENG Yun-zong;GUO Han-bing;HUANG Xing;KANG Fei;WANG Yuan-yuan;DONG Xun-hui;JIA Run-xia;WANG Hong-ling(The third affiliated hospital of Henan university of TCM,Zhengzhou 450003,Chin)

机构地区：[1]河南中医药大学第三附属医院,郑州450003

出　　处：《医药论坛杂志》2018年第6期18-22,共5页Journal of Medical Forum

基　　金：河南省科技厅2015科技攻关项目(152102310104)

摘　　要：目的观察亚砷酸循环腹腔热灌注化疗(hyperthermic intraperitoneal chemotherapy,HIPEC)治疗胃癌恶性腹水的临床疗效。方法选取2015年3月—2017年10月期间36例入住河南中医药大学第三附属医院肿瘤科的胃癌恶性腹水患者,应用随机数字表法将36例患者随机分成治疗组16例与对照组20例。对照组患者给予顺铂循环腹腔热灌注化疗治疗,而治疗组患者则给予亚砷酸循环腹腔热灌注化疗治疗。比较两组治疗前后患者的临床疗效,Kamofsky(KPS)评分与肿瘤标志物变化情况及不良反应发生情况。结果 2周期治疗后,治疗组有效率为43.75%显著高于对照组有效率的40%,两组比较差异有统计学意义P<0.05;治疗组控制率为75%,对照组控制率为65%,两组比较差异有统计学意义P<0.05。两组患者治疗前后Kamofsky(KPS)评分分别为:治疗组为(56.60±5.80)、(66.50±9.49),对照组为(56.25±6.28)、(68.25±8.44),两组治疗前后均有所提高P<0.05;但治疗后两组间比较,差异无显著统计学意义(P=0.382>0.05)。两组肿瘤标志物CEA、CA125、CA199均较治疗前明显降低,治疗前后两组间均无显著差异(P>0.05)。结论亚砷酸循环腹腔热灌注化疗能够较好地治疗胃癌恶性腹水患者,减少腹水的症状;可显著降低肿瘤标志物的水平与改善患者的Kamofsky活动状态评分,且不增加药物的毒副作用,安全性强,提高患者的生命质量。Objective To observe the clinical efficacy of hyperthermic intraperitoneal（ HIPEC） in the treatment of malignant ascites in gastric cancer. Methods From March 2015 to October 2017,36 patients with malignant ascites from gastric cancer admitted to the Third Affiliated Hospital of Henan University of Traditional Chinese Medicine were enrolled. 36 patients were divided into treatment group and control group by random number table method. 16 cases,control group of 20 cases. Patients in the treatment group were given intraperitoneal hyperthermic perfusion chemotherapy with arsenious acid,while patients in the control group were given intraperitoneal hyperthermic perfusion chemotherapy with cisplatin. The clinical efficacy,the Kamofsky（ KPS） score,the changes of tumor markers and the incidence of adverse reactions were compared between the two groups before and after treatment. Results After 2 cycles,the effective rate was 43. 75% in the treatment group and 40% in the control group,and the effective rate in the treatment group was significantly higher than that in the control group（ P〈0. 05）. The control rate in the treatment group was 75% higher than that in the control group 65%（ P〈0. 05）. The scores of Kamofsky（ KPS） in the two groups before and after treatment were 56. 60 ± 5. 80 and 66. 25 ± 8. 45 in the treatment group and 56. 25 ± 6. 28 and 68. 25 ± 8. 44 in the control group,both before and after treatment（ P〈0. 05） However,there was no significant difference between the two groups after treatment（ P = 0. 382〉 0. 05）. The tumor markers CEA,CA125 and CA199 in both groups were significantly lower than those before treatment,and there was no significant difference between the two groups before and after treatment（ P〉0. 05）. Conclusion Arsenious acid circulating intraperitoneal hyperthermic chemotherapy in patients with malignant ascites due to gastric cancer has better curative effect,can significantly improve the patient＇s Kamofsky activity score and reduce the leve

关 键 词：循环腹腔热灌注 胃癌恶性腹水 亚砷酸 顺铂 

分 类 号：R730.6[医药卫生—肿瘤]