目的 探讨细胞减灭术(CRS)后的晚期卵巢癌患者采用全身化疗联合顺铂腹腔热灌注化疗(HIPEC)治疗后的临床疗效及安全性.方法 选取2015年5月至2016年5月收治的健康情况尚可的卵巢癌患者90例,均同意接受细胞减灭术,采用随机数字法分为对照组(30例)、热疗组(30例)及热化疗组(30例).对照组患者单纯给予TP方案化疗治疗,热疗组患者在单纯化疗基础上给予腹腔热灌注治疗,而热化疗组患者则在单纯化疗的基础上给予顺铂腹腔热灌注治疗.治疗后,随访2年,比较三组患者的临床受益情况、随访时间内生存率、复发率的高低.并统计三组患者治疗2个周期后白细胞减少、恶心呕吐、腹痛腹泻、肝肾功能损害等不良事件的发生率.结果 治疗后,三组患者的临床疗效比较,热化疗组>热疗组>对照组,热化疗组显著优于其他两组(P0.05).结论 对于CRS术后的晚期卵巢癌患者的治疗中,常规化疗联合顺铂腹腔热灌注化疗优于联合腹腔热灌注治疗,而联合腹腔热灌注治疗优于单纯的常规术后化疗.临床效果良好,可提高生存率.降低复发率,并且不增加化疗药物毒副反应,安全性高,患者临床受益明显.%Objective To investigate the clinical efficacy and safety of systemic chemotherapy combined with cisplatin intraperitoneal hyperthermic perfusion chemotherapy(HIPEC)in patients with advanced ovarian cancer after cytoreductive surgery(CRS). Methods A total of 90 patients with ovarian cancer who were admitted to our hospital from May 2015 to May 2016 were enrolled. They all received cytoreductive surgery and were randomly divided into control group(30 cases)and hyperthermia Group(30 cases)and thermochemotherapy group(30 cases). Patients in the control group were treated with TP regimen alone. Patients in the hyperthermia group received peritoneal hyperthermia on the basis of chemotherapy alone,while patients in the thermochemotherapy group received cisplatin peritoneal hyperthermia on the basis of chemotherapy alone. After treatment,the patients were followed up for 2 years,and the clinical benefit,survival rate and recurrence rate of the three groups were compared. The incidence of adverse events such as leukopenia,nausea and vomiting,abdominal pain and diarrhea,and liver and kidney dysfunction after two cycles of treatment were counted. Results After treatment,the clinical efficacy of the three groups was compared. The thermochemotherapy group>the hyperthermia group>the control group and the thermochemotherapy group were significantly better than the other two groups(P0.05). Conclusion For the treatment of patients with advanced ovarian cancer after CRS,conventional chemotherapy combined with cisplatin peritoneal hyperthermic perfusion chemotherapy is superior to combined intraperitoneal hyperthermia,and combined intraperitoneal hyperthermia is superior to conventional postoperative chemotherapy. This therapy has good clinical effect,can improve the survival rate,reduce the recurrence rate,and does not increase the toxicity and side effects of chemotherapeutic drugs. It has high safety and obvious clinical benefits for patients.
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