紫杉醇联合顺铂腹腔热灌注化疗对胃癌恶性腹腔积液疗效的临床研究

摘要

ObjectiveTo explore the clinical curative effect to malignant ascites for advanced gastric cancer patients by paclitaxel combined with cisplatin abdominal continuous hot perfusion chemotherapy.Method104 cases of advanced gastric cancer patients were randomly divided into two groups, treatment group of 54 cases and control group of 50 cases, two groups of patients were given intravenous drip docetaxel 75 mg/m2 for the ifrst day (21 days); treatment group was given constant abdominal persistent circulation perfusion of cisplatin (set temperature 45℃) after releasing ascites, and control group was given with perfusion of cisplatin after releasing ascites; two groups of patients were given for once a week, 3 weeks as a course of treatment; detected the serum CEA levels and observed changes in malignant ascites after treatment of 3 weeks, 3 months and 6 months respectively.ResultThe effective rate of treatment group was 53.7%, and control group was 30.0%, and the difference was signiifcant between two groups (P<0.05); the concentration of serum CEA in treatment group was decreased obviously in the treatment of 3 months and was statistically differente compared with control group (P<0.05).ConclusionIntraperitoneal hot perfusion chemotherapy in the treatment of advanced gastric cancer malignant ascites is effective, and serum CEA markedly reduced.%目的：探讨紫杉醇联合顺铂腹腔持续热灌注化疗对晚期胃癌患者恶性腹腔积液的临床疗效。方法将104例晚期胃癌患者随机分为两组，试验组54例，对照组50例，两组患者治疗第1天均静脉滴注紫杉醇75 mg/m2（21天方案），试验组患者排出腹腔积液后恒温腹腔持续性循环灌注顺铂（设定温度45℃），对照组患者排出腹腔积液后灌注顺铂。两组患者均每周治疗1次，3周为一疗程；治疗后3周、3个月和6个月分别检测两组患者血清癌胚抗原（CEA）浓度并观察恶性腹腔积液变化。结果试验组有效率为53.7%，对照组有效率为30.0%，两组间比较有显著差异（P＜0.05）；试验组患者血清CEA浓度在治疗3个月后明显下降，且两组比较有显著差异（P＜0.05）。结论紫杉醇联合顺铂腹腔持续热灌注化疗治疗晚期胃癌恶性腹腔积液疗效肯定，且血清CEA浓度明显下降。