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目的:观察用多西他赛全身化疗和卡铂腹腔灌注化疗联合腹部高频热疗治疗晚期卵巢癌腹水患者的临床疗效及毒副反应。方法:34例晚期卵巢癌腹水患者,18例采用多西他赛全身化疗+卡铂腹腔灌注化疗,16例用多西他赛全身化疗+卡铂腹腔灌注化疗联合腹部高频热疗。多西他赛75 mg/m2,静脉滴注第1天,卡铂AUC=5,腹腔灌注给药第1天,高频热疗在腹腔灌注卡铂后2小时进行,以后隔日1次,21天为1周期,4周期后评价疗效。结果:常规化疗组的有效率为55.6%,高频热疗组的有效率为87.5%,两组差异有统计学意义(P<0.05);KPS评分,常规化疗组的改善率为61.1%,高频热疗组的改善率为93.8%,两组差异有统计学意义(P<0.05);化疗过程中的主要毒副反应是胃肠道反应、白细胞减少、血小板减少和脱发,差异无统计学意义(P>0.05);从第二周期化疗开始,高频热疗组腹水消退的患者明显较常规化疗组增多,两组间差异有统计学意义(P<0.05)。结论:用多西他赛全身化疗和卡铂腹腔灌注化疗联合腹部高频热疗可显著提高晚期卵巢癌腹水患者的治疗效果、改善患者的生活质量和控制腹水的生长,而不增加毒副作用。
Objective: To observe the clinical efficacy and toxicity of docetaxel systemic chemotherapy and carboplatin peritoneal perfusion chemotherapy combined with abdominal high frequency hyperthermia in the treatment of patients with advanced ovarian ascites. Methods: Thirty-four patients with advanced ascites of ovarian cancer were enrolled. Eighteen patients received chemotherapy with docetaxel plus intraperitoneal chemotherapy with carboplatin, and 16 patients received chemotherapy with docetaxel plus intraperitoneal chemotherapy with carboplatin combined with abdominal hyperthermia. Docetaxel 75 mg / m2, intravenous infusion on the first day, carboplatin AUC = 5, the first day of intraperitoneal perfusion, high frequency hyperthermia in the abdominal perfusion of carboplatin 2 hours after the next day, 21 Days for the 1 cycle, 4 cycles after the evaluation of efficacy. Results: The effective rate was 55.6% in conventional chemotherapy group and 87.5% in high frequency hyperthermia group, with significant difference between the two groups (P <0.05). The improvement rate of KPS score and routine chemotherapy group was 61.1% The improvement rate of high-frequency hyperthermia group was 93.8%, the difference between the two groups was statistically significant (P <0.05). The main toxicities during chemotherapy were gastrointestinal reaction, leukopenia, thrombocytopenia and hair loss with no statistical difference (P> 0.05). From the second cycle of chemotherapy, the patients with high-frequency hyperthermia ascites subsided obviously more than the conventional chemotherapy group, the difference was statistically significant (P <0.05). CONCLUSIONS: Docetaxel systemic chemotherapy combined with intraperitoneal chemotherapy with carboplatin and abdominal hyperthermia can significantly improve the therapeutic effect of ascites in patients with advanced ovarian cancer, improve the quality of life of patients and control the growth of ascites without increasing the toxic and side effects.