内生场热化治疗老年恶性浆膜腔积液

摘要

Objective: To observe the effects of local endogenetic thermotherapy combined with perfusion and intravenous chemotherapy for elderly patients with malignant serous effusion. Methods: 72 patients over 60 years old with malignant serous effusion diagnosed by pathology were treated with perfusion and intravenous chemotherapy. One of the drugs such as DDP, BLM, 5-FU, THP was injected into the serous cavity, 2-3 times per week, 3-4 weeks totally (3-4 times at means). Each time followed by local endogenetic thermotherapy, meanwhile, the intravenous chemotherapy began. Results: The response rate was 87.5% in 40 cases with malignant pleural effusion, 69.0% in 29 cases with ascites, 100.0% in 3 cases with malignant pericardial effusion. The effects of malignant serous effusion caused by the lung, breast, colon and ovarian cancer were better than others. The CD3+/HLA-DR+(activated T cell) was significantly rised after treatment (P<0.05). Conclusion: The effects of local endogenetic thermotherapy combined with chemotherapy for elderly patients with malignant serous effu -sion are significant, the mechanism may be related to the anti-tumor cellular immunity induced by the thermotherapy. The treatment caused mild sidereaction which is well tolerated, is well worth clinical popularizing and application.%目的:观察老年患者恶性浆膜腔积液腔内局部化疗+静脉全身化疗联合内生场热疗的疗效.方法:72例60岁以上老年患者恶性浆膜腔积液经病理检查诊断明确,根据原发肿瘤类型适当选择顺铂(DDP)、博来霉素(BLM)、5-氟尿嘧啶(5-FU)、吡柔比星(THP)腔内灌注化疗,腔内化疗每周2~3次,共3~4周,平均治疗3~4次.同时根据不同肿瘤选择静脉全身化疗,并以浆膜腔积液为中心,灌注当日行内生场热疗.结果:40例恶性胸腔积液有效率为87.5%,29例恶性腹腔积液有效率为69.0%,3例恶性心包积液有效率为100.0%,其中,肺癌、乳腺癌、肠癌及卵巢癌所致恶性浆膜腔积液疗效相对较好.各组治疗前后患者细胞免疫功能指标--活化T细胞(CD3+/HLA-DR+)治疗后较治疗前升高,两者比较,差异有统计学意义(P<0.05).结论:老年患者恶性浆膜腔积液内生场热化治疗疗效确切,其疗效可能与热疗诱发机体抗肿瘤免疫效应有关,患者毒副反应轻,可安全耐受,值得临床推广应用.