间歇性肿瘤细胞减灭术+腹腔热灌注化疗在晚期上皮性卵巢癌治疗中的应用  

Application of intermittent cytoreductive surgery+hyperthermic intraperitoneal chemotherapy in the treatment of advanced ovarian cancer

作　　者：张颖 杨波 印天 赵越 张新怡 李莹 ZHANG Ying;YANG Bo;YIN Tian;ZHAO Yue;ZHANG Xinyi;LI Ying(Department of Gynaecologic Oncology,the First Affiliated Hospital of Bengbu Medical University,Bengbu,Anhui 233004,China;不详)

机构地区：[1]蚌埠医科大学第一附属医院肿瘤妇科,安徽蚌埠233004 [2]联勤保障部队第902医院妇儿科,安徽蚌埠233000

出　　处：《中华全科医学》2024年第5期768-771,共4页Chinese Journal of General Practice

基　　金：安徽省高等学校自然科学研究项目(KJ2021A0727)。

摘　　要：目的探索在晚期上皮性卵巢癌治疗中采用间歇性肿瘤细胞减灭术+腹腔热灌注化疗(HIPEC)的有效性和安全性。方法选取蚌埠医科大学第一附属医院2020年11月—2021年9月诊断为晚期上皮性卵巢癌的患者90例,根据是否使用HIPEC分为观察组及对照组,每组各45例。比较2组患者近期疗效、术后及化疗后不良反应发生情况。结果观察组客观有效率(ORR)为86.7%,明显高于对照组的68.9%(P=0.043);观察组2年生存率为86.7%,高于对照组的64.4%(P=0.014);观察组无进展生存期(PFS)为(29.03±1.07)个月,明显高于对照组[(16.60±1.12)个月,P<0.001];化疗后不良反应中恶心/呕吐分级2组差异有统计学意义(P<0.05),肝功能损伤分级2组差异有统计学意义(P<0.05);术后不良反应中观察组腹胀、低蛋白血症的发生率分别为57.8%、37.8%,对照组分别为2.2%、2.2%,差异均有统计学意义(P<0.05)。结论采用间歇性肿瘤细胞减灭术联合HIPEC有望在控制范围内提高晚期上皮性卵巢癌患者的近期治疗效果,保证治疗的安全性。Objective To explore the efficacy and safety of intermittent cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy(HIPEC)in the treatment of advanced ovarian cancer.Methods Patients diagnosed with advanced ovarian cancer in the First Affiliated Hospital of Bengbu Medical University from November 2020 to September 2021 were selected.According to whether to use HIPEC,the patients were divided into an experimental group and a control group,with 45 cases in each group.The short-term outcomes and incidence of adverse effects after surgery and chemotherapy in two groups of patients were compared.Results The objective response rate(ORR)was 86.7%in the experimental group and 68.9%in the control group(P=0.043).The 2-year survival rate was 86.7%in the experimental group and 64.4%in the control group(P=0.014).The average progression-free survival(PFS)of the experimental group was(29.03±1.07)months,which was significantly higher than the control group[(16.60±1.12)months,P<0.001].The adverse reactions after chemotherapy in the two groups were statistically significant in nausea/vomiting(P<0.05),and liver function injury(P<0.05).The incidences of abdominal distension and hypoproteinemia were 57.8%and 37.8%in the experimental group,and 2.2%and 2.2%in the control group,respectively(P<0.05).Conclusion The use of intermittent cytoreductive surgery combined with HIPEC is expected to improve the short-term treatment effect of patients with advanced ovarian cancer within a controlled range and ensure the safety of treatment.

关 键 词：卵巢癌 肿瘤细胞减灭术 腹腔热灌注化疗 近期疗效 不良反应 

分 类 号：R737.31[医药卫生—肿瘤] R730.53[医药卫生—临床医学]