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目的探讨腹腔热灌注化疗联合贝伐珠单抗治疗卵巢癌腹腔积液的疗效及生活质量。方法选取临朐县人民医院2013年6月至2015年6月间收治的80例卵巢癌腹腔积液患者,采取随机数字表法分为观察组和对照组,每组40例。两组患者均给予紫杉醇联合卡铂行全身化疗,同时给予腹腔内顺铂热灌注化疗,以6周为1个疗程。观察组患者在此基础上于每次热灌注化疗腹腔内注入贝伐珠单抗,6周为1个疗程。对比两组患者的临床疗效,治疗前后腹水中血管内皮生长因子(VEGF)水平,两组患者的生活质量及不良反应。结果与对照组相比,观察组患者的有效率和疾病控制率明显增加,差异均有统计学意义(P<0.05)。与治疗前相比,两组患者治疗后VEGF水平均有所降低;治疗后,观察组患者的VEGF水平低于对照组,差异有统计学意义(P<0.05)。与对照组相比,观察组患者躯体功能、角色功能、认知功能、情绪功能和社区功能评分均明显降低,差异均有统计学意义(均P<0.05)。两组患者发热、白细胞减少、恶心呕吐、疼痛、疲乏和体重减轻发生率的差异均无统计学意义(均P>0.05)。结论采用腹腔热灌注化疗联合贝伐珠单抗治疗卵巢癌腹腔积液疗效显著,可降低VEGF水平,改善生活质量,且不良反应较少,安全性较高。
Objective To investigate the efficacy and quality of life of intraperitoneal hyperthermic chemotherapy combined with bevacizumab in the treatment of patients with ovarian cancer. Methods Eighty patients with ascites from ovarian cancer who were treated in Lintao County People’s Hospital from June 2013 to June 2015 were randomly divided into observation group and control group with 40 cases in each group. Two groups of patients were given paclitaxel combined carboplatin line chemotherapy, while intraperitoneal cisplatin hot perfusion chemotherapy to 6 weeks for a course of treatment. On the basis of this, patients in the observation group were injected intraperitoneally with bevacizumab for each heat-perfusion chemotherapy, and the course of treatment was 6 weeks. The clinical efficacy, the level of vascular endothelial growth factor (VEGF) in ascites before and after treatment, the quality of life and the adverse reactions in both groups were compared between the two groups. Results Compared with the control group, the effective rate and disease control rate in the observation group were significantly increased, the differences were statistically significant (P <0.05). Compared with those before treatment, VEGF levels decreased after treatment in both groups. After treatment, VEGF level in observation group was lower than that in control group (P <0.05). Compared with the control group, the body function, role function, cognitive function, emotional function and community function scores of the observation group were significantly lower (all P <0.05). There was no significant difference in the incidence of fever, leukopenia, nausea, vomiting, pain, fatigue and weight loss between the two groups (all P> 0.05). Conclusion Intraperitoneal hyperthermic chemotherapy combined with bevacizumab is effective in treating patients with ascites due to ovarian cancer, which can reduce the level of VEGF and improve the quality of life with less adverse reactions and higher safety.