卡铂联合5-氟尿嘧啶腹腔热灌注治疗恶性腹腔积液临床研究

摘要

目的 探讨卡铂联合5-氟尿嘧啶(5-fluorouracil,5-FU)腹腔热灌注治疗恶性腹腔积液近期疗效及对免疫功能的影响.方法 61例恶性腹腔积液患者采用卡铂联合5-FU腹腔热灌注化疗,1次/周,完成4次治疗评估效果.结果 有效率为80.33%,完全缓解(complete response,CR)率为49.18%.结肠癌、卵巢癌有效率最高均为100.00%,CR率为91.67%和90.00%,明显高于其他病种(P＜0.01).治疗后外周血及腹腔积液白细胞介素10(interleukin,IL-10)、IL-6水平均显著降低(P＜0.01),IL-2、干扰素γ(interferon-γ,IFN-γ)水平均显著升高(P＜0.01).治疗后卡氏功能状态(Karnofsky performance status,KSP)评分均显著升高(P＜0.01).结论 卡铂联合5-FU腹腔热灌注治疗恶性腹腔积液疗效确切,安全性高,对抗肿瘤免疫功能有调节作用,临床应用价值高.%Objective To explore the short-term efficacy and effect of intraperitoneal hyperthermic perfusion chemotherapy (IHPC)of carboplatin and 5-fhiorouracil(5-FU)on immunologic function in the treatment of malignant ascites. Methods Carboplatin and 5-FU were used in IHPC in 61 patients once a week,the effects were evaluated after 4 weeks treatment. Results The effective rate was 80. 33% , the complete response(CR) rate was 49. 18% . The effective and CR rate of colon cancer and ovarian cancer were higher than others (P<0. 01). The level of interleukin-10 (IL-10), IL-6 in peripheral blood and malignant ascites were significant decreased (P<0. 01). The level of IL-2, interferon-γ(IFN-γ) in peripheral blood and malignant ascites were significant increased(P<0. 01). The Karnofsky performance status (KSP) was significant increased (P<0. 05). Conclusion IHPC of carboplatin and 5 -FU in treatment of malignant ascites were effective and safe, and could regulate the antineoplastic immune function with a good clinical application value.