多西他赛联合顺铂或洛铂腹腔灌注治疗晚期卵巢癌合并腹水疗效比较

摘要

Objective To evaluate efficacy and toxicity of cisplatin and lobaplatin in intraperitoneal perfusion chemotherapy for ad -vanced ovarian cancer with ascites .Methods Retrospective analysis was used to analyze the clinical materials of 36 cases about postopera-tive advanced ovarian cancer in Oncology Department of the People′s Hospital, Province Guizhou from January 2011 to December 2012, with 16 cases in cisplatin group(A group) and 20 cases in lobaplatin group(B group).Docetaxel chemotherapy was used on all the patients during intraperitoneal perfusion .Results There was no significant difference in CA 125 between A group and B group in first pre and post chemotherapy (P>0.05).There was no statistical significance between two groups after the second ,third and fourth cycle chemotherapy (P>0.05).But for the patients with gross residual disease ,after the first or second cycle chemotherapy , CA125 levels in A group were lower than that in B group (P<0.05).There were no statistical significance between two groups in the toxicities of hemoglobin , lower white blood cell, digestive disturbance and liver function damage;but A group were higher than that in B group in platelet decrease and renal function damage.Conclusion Intraperitoneal perfusion chemotherapy with cisplatin or lobaplatin is efficient and suitable for the advanced ovarian cancer with ascites after optimally cytoreductive surgery ,but cisplatin lowered recent CA 125 level will get sooner result than lobaplatin for those with gross residual disease .%目的：探讨顺铂与洛铂在晚期卵巢癌腹腔化疗中的疗效及副反应。方法我科对2011-01～2012-12间收治的36例晚期卵巢癌术后患者进行回顾性分析，顺铂组16例，洛铂组20例，两组患者腹腔灌注时均予多西他赛全身化疗。结果两组患者CA125值术前与第1次灌注化疗前比较，无统计学差异（ P＞0.05）。第1次灌注化疗后，顺铂组与洛铂组比较无统计学意义（ P＞0.05），而第2次、第3次及第4次化疗后两组的CA125值比较，仍无统计差异（ P＞0.05）；顺铂组与洛铂组术后有肉眼残留病灶的患者经第1次与第2次化疗后，顺铂组的CA125降到更低水平（ P＜0.05）；两组在副反应方面（血红蛋白下降、白细胞下降、肝功能损伤及消化道反应方面）顺铂组与洛铂组无统计学差异，肾功能损伤发生率顺铂组高于洛铂组，血小板下降发生率顺铂组低于洛铂组。结论晚期卵巢癌患者经过肿瘤细胞减灭术后合并腹水，予顺铂或洛铂行腹腔灌注化疗，并结合多西他赛全身化疗，均有效可行，而对有肉眼残留病灶的患者，予顺铂腹腔灌注化疗可能在比较短的疗程内见效。