目的 探讨奥沙利铂腹腔热灌注治疗卵巢癌的临床疗效。方法 选取2017年1月—2019年1月治疗的晚期卵巢癌患者68例,根据治疗方案分为观察组（n=35）和对照组（n=33）,两组均给予多西他赛静脉滴注,其中观察组给予奥沙利铂腹腔热灌注,对照组给予奥沙利铂静脉滴注,观察两组治疗疗效、不良反应、无进展生存期等。结果 观察组化疗疗效优于对照组（P<0.05）,其化疗总有效率为74.29%;观察组治疗后腹水量为（760.35±110.21） mL,明显低于对照组（P<0.05）;观察组治疗后血清糖类抗原125（CA125）和鳞状细胞癌抗原（SCCA）为（12.21±2.15） U/mL和（8.28±1.82） ng/mL,明显低于对照组（P<0.05）;观察组无进展生存期为15个月（95%CI：13.21~16.79）,明显长于对照组,差异比较有统计学意义（P<0.05）;观察组和对照组不良反应比较差异无统计学意义（P>0.05）。结论 奥沙利铂腹腔热灌注治疗卵巢癌有较好的临床疗效,延长生存期。
Objective To investigate the clinical effect of intraperitoneal hyperthermic perfusion with oxaliplatin on ovarian cancer. Methods A total of 68 patients with advanced ovarian cancer treated in our hospital from January 2017 to January 2019 were divided into an observation group （n=35） and a control group （n=33） according to treatment plans. Both the groups were given docetaxel through intravenous drip. The observation group was additionally given oxaliplatin intraperitoneal thermal perfusion, while the control group was additionally given oxaliplatin intravenous drip. The treatment effects, adverse reactions, and progression-free survival of the two groups were observed. Results The total curative effective rate of chemotherapy in the observation group was 74.29%, higher than that in the control group （P<0.05）. The ascites volume of the observation group after treatment was （760.35±110.21） mL, which was significantly lower than that of the control group （P<0.05）. The levels of serum carbohydrate antigen 125 （CA125） and squamous cell carcinoma antigen （SCCA） in the observation group were （12.21±2.15） U/mL and （8.28±1.82） ng/mL, respectively, which were significantly lower than those in the control group （P<0.05）. The progression-free survival of the observation group was 15 （95%CI： 13.21-16.79） months, which was significantly longer than that of the control group （P<0.05）. There was no significant difference in adverse reactions between the observation group and the control group （P>0.05）. Conclusion Oxaliplatin intraperitoneal hyperthermic perfusion has a good clinical effect on ovarian cancer and prolongs survival.
[1] 王安凤,潘晨,童晓文.TLR4/MyD88信号通路在卵巢癌紫杉醇化疗抵抗中的研究进展[J].外科研究与新技术, 2019,8(1):49-53.
[2] Long, Li, Zhou, et al. Long non-coding RNA LSINCT5 promotes ovarian cancer cell proliferation, migration and invasion by disrupting the CXCL12/CXCR4 signalling axis[J]. Oncol Lett, 2018,12(11):121-128.
[3] Mas-Fuster M I,Ramon-Lopez A,Lacueva F J, et al. Population pharmacokinetics of oxaliplatin after intraperitoneal administration with hyperthermia in Wistar rats[J]. EUR J Pharm Sci, 2018,119(23):22-30.
[4] 陈进宝,邱艳艳,徐可,等.FOLFOX方案与XELOX方案治疗中晚期结肠癌患者疗效和安全性的meta分析[J]. 外科研究与新技术, 2019,8(2):73-83.
[5] Hong F G, Zhou L,Huang J,et al.Intraperitoneal oxaliplatin administration inhibits the tumor immunosuppressive microenvironment in an abdominal implantation model of colon cancer[J]. Mol Med Rep, 2018,18(2):344-347.
[6] 钱国武,张海洋,王新伟,等.术中及术后早期腹腔热灌注化疗在局部进展期胃癌的临床价值[J].重庆医学,2018,47(14):94-96.
[7] Taylor S E,Petschauer J S,Donovan H,et al.Phase I study of intravenous oxaliplatin and intraperitoneal docetaxel in recurrent ovarian cancer[J]. Int J Gunecol Cancer, 2019,29(1):147-152.
[8] Rebecca S B, Liina P, Eric J, et al.Risk of malignant ovarian cancer based on ultrasonography findings in a large unselected population[J]. Jama Internal Med, 2019,179(5):226.
[9] 王丹,代晶,潘长清,等.血清CA125、HE4以及ROMA指数在卵巢癌早期诊断中的应用价值[J].实用妇产科杂志,2018, 34(4):314-316.
[10] He M, Sun J, Zhao D, et al.Modified-FOLFIRINOX combined with deep regional hyperthermia in pancreatic cancer: a retrospective study in Chinese patients[J]. Int J Hyperther, 2019,12(23):1-9.
[11] 雷子颖,关天培,罗嘉莉,等.局部进展期结直肠癌原发肿瘤切除术后5~8周行腹腔热灌注化疗的合理性[J].中华胃肠外科杂志, 2019,22(12):1115-1117.
[12] Shuang F, Bi S,Xin Z, et al.Analgesic effect of AG490, a Janus kinase inhibitor, on oxaliplatin-induced acute neuropathic pain[J]. Netral Regen Res, 2018,13(8):1471-1476.
[13] 刘轩宇. 外泌体在胃癌腹膜转移中机制的研究进展[J]. 外科理论与实践,2021,26(1):76-78.
[14] 段文丽,张燕,张琼,等.CIK联合TP方案治疗复发性卵巢癌的临床疗效观察[J].重庆医学,2019,48(8):1323-1326.
[15] Hong X, Dong T, Yi T, et al.Impact of 5-Fu/oxaliplatin on mouse dendritic cells and synergetic effect with a colon cancer vaccine[J]. Chinese J Cancer Res, 2018,30(2):45-56.
[16] 李晶,林仲秋.妇科恶性肿瘤腹腔热灌注化疗临床应用专家共识(2019)[J].中国实用妇科与产科杂志, 2019,35(2):62-69.
[17] Dumont F, Boisdron-Celle M, Hiret S, et al.Phase I/II study of oxaliplatin dose escalation via a laparoscopic approach using pressurized aerosol intraperitoneal chemotherapy (PIPOX trial) for nonresectable peritoneal metastases of digestive cancers (stomach, small bowel and colorectal)[J]. J Clin Oncol, 2019,37(15):15027.
[18] 姬忠贺,于洋,刘刚,等.肿瘤细胞减灭术加腹腔热灌注化疗治疗胃癌腹膜转移的预后列线图构建与验证[J].中华普通外科杂志, 2019,34(10):833-836.
