射频热疗加腹腔热灌注化疗联合静脉双途径

    化疗治疗恶性腹水疗效分析

    范 娟 ,吴天革 ,杨渝沙 ,谭燕琼 ,吴敬波

    (泸州医学院附属医院肿瘤科 , 四川 泸州 646000)

    [摘要] 目的:探讨射频热疗加腹腔热灌注化疗和静脉双途径化疗治疗恶性腹水的疗效和毒副反应。方法:

    20例恶性腹水患者采用常规腹腔穿刺 ,放置中心静脉导管 ,尽量引流腹水彻底后 ,将 43 ℃无菌生理盐水 1 500～

    2 000 ml 加 52FU 0. 5～1. 0g经导管快速滴入腹腔 ,第 1、 4、 8、 11 天 ,然后沿导管放置传感器进行腹腔温度的测定 ,随后行腹部 SR21000型射频透热治疗 70 分钟 ,并同时进行全身静脉化疗 ,奥沙利铂 100 mg第 1、 8 天或顺铂 40～

    60 mg第 1、 8 天 , 21天为一周期。结果:全组患者最高治疗温度为 43. 5℃,最低治疗温度为 40. 5℃,平均治疗温度

    41. 5℃。腹水有效率为90 %(18/ 20) ,盆、腹腔肿瘤有效率为 58. 8 %(10/ 17) ,全组患者中位生存期 10个月,一年生存率

    75 %。脂肪硬结发生率20 %,腹痛发生率为25 %,其他毒副反应较轻,能耐受。结论:射频热疗加腹腔热灌注化疗和静脉

    双途径化疗治疗恶性腹水疗效高,毒副反应轻,且对腹、盆腔肿瘤病灶也有较好的疗效,值得进一步的推广应用。

    [关键词] 射频热疗; 热灌注化疗; 静脉化疗; 恶性腹水

    中图分类号:R735 ,R737 文献标识码:A 文章编号:100723639 (2004) 0620565202

    Radiofrequency chemohyperthermia combined with intravenous chemotheray for mal ignant ascites

    FA N J uan , WU Tian2ge , YA N G Y u2 sha , et al (Department of Oncology , A f f i l iated Hospi tal of

    L uz hou Medical Col lege ,L uz hou S ichun 646000 , China)

    [ Abstract] Purpose : To evaluate the efficacy and tolerance of radiof requency chemohyperthermia combined with in2

    t ravenous chemotherapy for malignant ascites. Methods : Twenty patients with malignant ascites received the t reatment .

    After abdominal cavity aspiration and infusion of hot 0. 9 % sodium chloride in jection 1 50022 000 ml with 52FU , Esti2

    mated the temperature of abdominal cavity was estimated with a sensor , then t reated with SR 21000 radiof requency hyper2

    thermia for 70 minutes and chemothera py at the same time. The radiof requency chemohyperthermia with 52FU 0. 521. 0 g

    was given d 1 ,4 ,8 ,11 and int ravenous chemothera py with oxaliplatin 100 mg was given d 1 ,8 or cis platin 40260 mg d 1 ,8. Results : The average t reatment temperature was 41. 5℃in 20 cases. The highest was 43. 5℃and lowest temperature

    was 40. 5℃. The response rate of ascites was 90 %(18/ 20) The response rate of peritoneo2pelvic tumor was 58. 8 %(10/

    17) . 12year overall survival rate is 75 %. The common side 2effects were fat necrosis (20 %) and adominal pain (25 %) .

    Conclusions :Radiof requency chemohyperthermia combined with int ravenous chemothera py appears to have a relatively

    high response with low side 2effects for malignant ascites and good response for peritoneo2pelvic malignant tumors.

    [ Key words] radiof requency hyperthermia ; chemohyperthermia ; int ravenous chemotherapy ; malignant as2

    cites

    第一作者简介:范 娟,女, 副主任医师 ......