摘要
目的评价检测腹水中血管内生长因子水平、腹腔灌注顺铂联合沙利度胺在晚期卵巢癌维持治疗中的临床意义。方法回顾性分析不能耐受联合或强烈化疗、腹水检测血管内皮生长因子（VEGF）阳性的晚期卵巢癌患者69例的临床资料。腹腔灌注顺铂（DDP）联合沙利度胺（实验组）患者36例，单纯腹腔灌注顺铂患者（对照组）33例，具体方法如下：腹腔灌注顺铂40～60mg／m2，1次／周，连续应用两次，4周为一周期，同时口服沙利度胺，治疗2个周期评价临床疗效、免疫功能及不良反应。结果实验组有效率为72．2％，对照组有效率为46．9％，两组差异具有统计学意义。实验组、对照组治疗前与治疗2个周期后腹水VEGF水平相比，差异均具有统计学意义；实验组VEGF的下降幅度高于对照组VEGF的下降幅度。实验组、对照组治疗前与治疗2个周期后T淋巴细胞亚群百分率相比，差异均无统计学意义。实验组Ⅲ～Ⅳ级恶心呕吐发生率低于对照组，两组差异具有统计学意义；而实验组其它Ⅲ-Ⅳ级不良反应（如中性粒细胞减少、血红蛋白减少、疲倦）发生率与对照组相比，两组差异无统计学意义。结论检测腹水中VEGF水平可提高恶性腹水的诊断率，腹腔灌注化疗药物联合沙利度胺治疗晚期卵巢癌恶性腹水有效率高，降低腹水中VEGF水平，提高生活质量，减轻不良反应，患者耐受性和依从性好。
Objective To evaluate the clinical value of detecting vascular endothelial growth factor （VEGF） in ascites and infusing cisplatin （DDP）in combination with thalidomide into abdominal cavity as mainte- nance therapy for advanced ovarian cancer. Methods 69 patients medical records of no combined chemotherapy tolerance and positive aseites VEGF in advanced ovarian cancer were analyzed retrospectively. 36 were enrolled into the trial groupe（ infusing eisplatin and thalidomide into abdominal cavity） , and 33 were enrolled into the control groupe（the only abdominal eisplatin infusion）. Therapies were take as follow： DDP（40 -60/m2） was given once a week for 2 weeks, and repeated with an interval of 2weeks. every 28 day was a cycle. Thalidomide was given continuously. Efficacy and toxicity and immune function were evaluated after 2 cycles. Results Respone rate of the trial groupe was 72.2%, and respone rate of the control group was 46.9%, differences between the two groups was significant in statistics science（P 〈 0.05）. VEGF level before treatment and after 2 cycles treatment were different in the two groups（ P 〈 0.01 ）. VEGF descent degree of the trial groupe was higher than that of the contronl. The percent of CD3 ＋ ,CD4 ＋ ,CD8 ＋ and CD4 ＋/CD8 ＋ in front of treatment and behind of 2 cycles treatment were no differences in the two groups, differences was significant in statistics science （ P 〉 0.05 ）. The rate of III - IV gastroenteric toxicity in the trial groupe was less than that in the control groupe（ P 〈 0.05 ）. But, the rate of other III - IV toxicity （ for example ： neutrocytopenia, hemoglobin descent, weakness ） were no significant difference t in two groups （ P 〉 0. 05 ）. Conclusion Detecting VEGF in ascites can increase diagnosis rate of malignant ascites. Infusing DDP into abdominal cavity in combination with thalidomide can raise respone rate in advanced ovarian cancer,reduce VEGF level of ascites, improve live quality and reduce adverse reaction. Patients tolerance and compliance are satisfactory.
出处
《实用肿瘤学杂志》
CAS
2012年第5期443-448,共6页
Practical Oncology Journal
关键词
血管内皮生长因子
腹水
晚期卵巢癌
Vascular endothelial growth factor
Ascites
Advanced ovarian cancer
