Clinical Observation On Cycle Thermochemotherapy Of Intraperitoneally Perfusion For Malignant Peritoneal Effusion

BACKGROUNDMalignant peritoneal effusion is the liquid caused by malignant tumors retentioning abnormally in abdominal cavity. It is seen frequently in the malignant tumors of mammary gland,bronchus, ovaries, stomach, pancreas, colon, etc. Cancers with malignant peritoneal effusion usually belongs to advanced stage. The one year survival rate is less than 10%. Generous ascitic fluid can increase the pressure of abdominal cavity, cause abdominal pain , dyspernier respiration, appetite descent, nausea and disgorging, etc. It is one of main factors depressing the quality of life of patients. It has important significance on relieving suffering and lengthening life span if we can effectively rein malignant peritoneal effusion. Abdominal cavity perfusion is usually combined with chems,diuresis,abdominal paracentesis to rein rapidly increasing ascites. The abdominal cavity perfusion has the better effect even when the treatment on all over the body is invalid. Thermotherapy is one of the methods of combined therapy of tumour,it is a relatively ideal adjuvant therapy method. Experiments show that tumor cells can be killed at over 42℃. There has got initial effect on threating malignant peritoneal effusion by abdominal cavity thermoperfusion chemotherapeutics, abdominal cavity thermoperfusion chems has distinct pharmacokinetics ascendancy and lukewarm effect. In traditional treatment method, heated chemotherapeutics are inserted into abdominal cavity or chemotherapeutics is perfused into abdominal cavity then we heat abdominal cavity by microwave, but those methods are difficult to ensure that there is permanent effective thermotherapy temperature in abdominal cavity,so curative effect is limited. Abdominal cavity extracorporeal circulation thermoperfusion chems machine can deal with those problems and there is not report about abdominal cavity extracorporeal circulation thermoperfusion chems. We treated patients by abdominal cavity extracorporeal circulation thermoperfusion chems or simple thermoperfusion chems and observed the treatment effect.OBJECTIVETo observe the clinical effect and dysreaction of cycle thermochemotherapy of intraperitoneally perfusion for malignant peritoneal effusion.METHODS1.We chose those patients accepting treatments in our thermotherapy center after Jan 2007, all patients are confirmed as malignant peritoneal effusion by pathology and divided into testing group or control group by gradation randomization;2.Carrying out equilibrium analysis on the basic status of testing group and control group;3.All patients adopt abdominal paracentesis and irrigation technique; 4.Testing group adopts abdominal cavity extracorporeal circulation thermoperfusion chems,control group adopts simple thermoperfusion chems;5.Recording observation index: perfusion fluid afferens amount,efferens amount and temperature; ascitic amount; laboratory examination; adverse effect;6.Decision of curative effect of seroperitoneum, graduation of adverse effect, carrying out statistical treatment.RESULTS1.The total effective rate of ascites treatment on testing group is 93.1%, the total effective rate of ascites treatment on control group is 66.7%(P<0.025) ;2.The incidence rate of hyperhidrosis in treatment on testing group is 89.7%, the incidence rate of hyperhidrosis in treatment on control group is 29.6%(P<0.05) .CONCLUSIONCycle thermochemotherapy of intraperitoneally perfusion for malignant peritoneal effusion is an effective and well tolerated method for the malignant peritoneal effusion with slight side-effect.