Efficacy and safety of hyperthermic intraperitoneal chemotherapy combined with systemic treatment in the management of malignant ascites
10.12025/j.issn.1008-6358.2023.20231553
- VernacularTitle:腹腔热灌注化疗联合系统化疗治疗恶性腹水的疗效和安全性
- Author:
Xian-Min LI
1
;
Wei YUAN
;
Yong CHEN
;
Tian-Shu LIU
;
Yue-Hong CUI
Author Information
1. 苏州市相城人民医院肿瘤内科,苏州 215131
- Keywords:
malignant ascites;
hyperthermic intraperitoneal chemotherapy;
paclitaxel;
gastric cancer
- From:
Chinese Journal of Clinical Medicine
2023;30(6):975-980
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the clinical efficacy and safety of hyperthermic intraperitoneal chemotherapy(HIPEC)combined with systemic treatment in solid tumor with malignant ascites(MA).Methods The clinical data of 88 patients with MA who received HIPEC combined with systemic treatment in Department of Medical Oncology,Zhongshan Hospital,Fudan University from July 2020 to December 2022 were retrospectively analyzed.The control rate of MA was analyzed,and the clinicopathological characteristics of patients with effective and noneffective MA treatment were compared.The Kaplan-Meier method was used to analyze the MA control time of patients with gastric cancer and non-gastric cancer,and patients who used and did not use paclitaxel(PTX).The differences in peripheral blood immune cells before and after treatment were compared.Results Until May 31,2023,the overall control rate of HIPEC combined with systemic chemotherapy for MA was 72.73%(64/88),and the median control time was 5.82 months.There was no difference in serum albumin level,systemic treatment regimen and perfusion times etc.between the effective group and the noneffective group.There were differences in the short-term efficacy of MA among patients with different primary tumor,and the control rate of gastric cancer was higher than that of non-gastric cancer(82.69%vs 58.33%,P=0.023).Kaplan-Meier analysis showed that there was no difference in ascites control time between gastric cancer and non-gastric cancer patients(7.50 months vs 5.29 months,P=0.354);compared to non-PTX medicine such as 5-fluorouracil(5-FU)and cisplatin(DDP),PTX significantly prolonged the control time of ascites(6.44 months vs 2.73 months,P=0.024).After treatment,CD4+T/CD8+T rate elevated.48.86%(43/88)patients had mild abdominal distension and abdominal pain,which could be relieved in a short time after treatment;4.55%(4/88)patients discontinued anti-tumor treatment because of digestive adverse effects.Conclusions HIPEC combined with systemic chemotherapy is safe and effective for MA and has a better short-term efficacy for gastric cancer,and PTX as the perfusion agent for HIPEC can prolong the control time of MA.
