主动循环热灌注化疗联合细胞减灭术对铂类药敏感型复发性卵巢癌的疗效分析  

Curative effect analysis of active circulating hyperthermic intraperitoneal chemotherapy combined with cytoreductive surgery for platinum-sensitive relapsed ovarian cancer

作　　者：宋春艳 孙淑华[1] Song Chunyan;Sun Shuhua(Department of Obstetrics and gynecology,Ordos Central Hospital Kangbashi Department,Ordos Inner Mongolia O17000,P.R.China)

机构地区：[1]内蒙古鄂尔多斯市中心医院康巴什部妇产科,内蒙古鄂尔多斯017000

出　　处：《中国计划生育和妇产科》2024年第11期90-94,共5页Chinese Journal of Family Planning & Gynecotokology

摘　　要：目的 探究主动循环热灌注化疗(HIPEC)联合细胞减灭术(CRS)治疗铂类药敏感型复发性(PSR)卵巢癌的效果。方法 选取2018年1月至2021年1月期间鄂尔多斯市中心医院收治的93例PSR卵巢癌患者,采用随机数字表法将其分为两组,观察组47例,对照组46例,对照组行CRS,术后配合TP化疗;观察组行CRS,术后进行主动循环HIPEC治疗。评估两组患者治疗3个疗程后的疗效,检测患者细胞免疫功能(CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))及肿瘤糖蛋白指标[血清人附睾蛋白4(HE4)、糖蛋白125(CA125)、血管内皮生长因子(VEGF)],观察治疗方案的安全性,分析患者生存情况。结果 观察组总有效率(ORR)[85.11%(40/47)]高于对照组[65.22%(30/46)],差异有统计学意义(P<0.05);两组治疗后CD4^(+)、CD4^(+)/CD8^(+)水平均升高,CD8^(+)、VEGF、CA125及HE4水平降低(P<0.05);观察组CD4^(+)、CD4^(+)/CD8^(+)水平高于对照组,CD8^(+)、VEGF、CA125及HE4水平低于对照组(P<0.05);两组恶心呕吐、血小板减少、白细胞减少、发热及骨髓抑制等药物不良反应发生率比较,差异均无统计学意义(P>0.05);观察组、对照组平均生存时间分别为(55.30±0.88)个月、(42.45±2.92)个月;经Log-Rank检验,两组生存曲线差异有统计学意义(Log-Rank χ^(2)=4.030,P=0.045)。结论 主动循环HIPEC联合CRS能够提高PSR卵巢癌的疗效,改善细胞免疫,减少肿瘤糖蛋白表达,且不增加不良反应,安全有效。Objective To investigate the efficacy of active circulating hyperthermic intraperitoneal chemotherapy(HIPEC)combined with cytoreductive surgery(CRS)in the treatment of platinum-sensitive relapsed ovarian cancer(PSR).Methods A total of 93 patients with PSR ovarian cancer were selected from January 2018 to January 2021 in Ordos Central Hospital.The patients were divided into two groups by random number table method:observation group(47 cases)and control group(46 cases).The control group received CRS and TP chemotherapy after surgery,while the observation group received CRS and active circulating HIPEC after surgery.The efficacy of the patients after 3 courses of treatment was evaluated,and the cellular immune function(CD4^(+),CD8^(+),CD4^(+)/CD8^(+))and tumor glycoprotein indexes[Serum human epididymal protein 4(HE4),glycoprotein 125(CA125),vascular endothelial growth factor(VEGF)]were detected.The safety of treatment was observed and the survival of patients was analyzed.Results The overall response rate(ORR)in observation group[85.11%(40/47)]was higher than that in control group[65.22%(30/46)],and the difference was statistically significant(P<0.05).After treatment,the levels of CD4^(+),CD4^(+)/CD8^(+)were increased,and the levels of CD8^(+),VEGF,CA125 and HE4 were decreased in both groups(P<0.05).The levels of CD4^(+),CD4^(+)/CD8^(+)in observation group were higher than those in control group,and the levels of CD8^(+),VEGF,CA125 and HE4 were lower than those in control group(P<0.05).There were no significant difference in the incidence of adverse drug reactions such as nausea and vomiting,thrombocytopenia,leukopenia,fever and myelosuppression between two groups(P>0.05).The average survival time of observation group and control group were(55.30±0.88)months and(42.45±2.92)months,respectively.By Log-Rank test,the survival curves of the two groups were significantly different(Log-Rank χ^(2)=4.030,P=0.045).Conclusion Active circulating HIPEC combined with CRS can improve the efficacy of PSR ovarian cancer,improve

关 键 词：铂类药敏感型复发性卵巢癌 主动循环热灌注化疗 细胞减灭术 疗效 

分 类 号：R737.31[医药卫生—肿瘤]