| Background and ObjectiveOvarian cancer is one of the most common malignant tumors of female genital system and the incidence rate is lower than cervical cancer,endometrial cancer,but the mortality rate of gynecological malignancies ranks first.Ovarian epithelial tumors are the most common ovarian tumors,accounting for ovarian malignancies 85%～90%,which is a serious threat to women’s health.According to the NCCN in 2015 pointed out that the current standard treatment of advanced epithelial ovarian cancer consists of optimal cytoreductive surgery to obtain a full stage,which removes all the visible lesion as far as possible or makes the residual leisions less than 1cm,systemic chemotherapy,radiotherapy,biological therapy and other comprehensive treatment.At present,surgery is still the primary treatment of ovarian cancer,but advanced ovarian cancer has been widely intraperitoneal metastasis and is the tendency to disseminate into peritoneal cavity,so there are still smaller residual lesions and cancer cells after optimal cytoreductive surgery.Most patients are relatively sensitive to platinum-based chemotherapy,but due to the blood-peritoneal barrier intravenous chemotherapy is difficult to achieve local drug concentration,which results high recurrence rate and poor prognosis.Intraperitoneal chemotherapy directy places chemotherapeutic drugs in the abdominal cavity whichi may increase the contact area with malignant tumors,in order to improve local drug concentration and curative efficacy.Intraperitoneal hyperthermic perfusion chemotherapy(IHPEC)has played a very good effect in the treatment of gastrointestinal cancer.IHPEC can increase the local heating of the tumor to up a certain temperature for a certain period of time,which both kills tumor cells and without damages normal tissue in order to treat cancer.In recent years,the intraperitoneal hyperthermic perfusion combined with intravenous chemotherapy has been applied to ovarian cancer,but there is no uniform standard for perfusion drugs and perfusion time.In this study,the clinical efficacy and safety of IHPEC combined with intravenous chemotherapy for ovarian cancer were studied so that provides more treatment for advanced ovarian cancer.Materials and methods1.Source of Materials: To analysis the clinical data of 74 patients who were diagnosed ovarian cancer with clinical stage III～IV in the Second Affiliated Hospital of Zhengzhou University from from January 2011 to June 2015.74 patients with advanced ovarian cancer were randomly divided into two groups: experiment group of 35 patients(intraperitoneal hyperthermic chemotherapy with 5-fluorouracil and carboplatin after cytoreductive surgery combined with intravenous chemotherapy),control group of 39 patients(intravenous chemotherapy after cytoreductive surgery).The experiment aims to observe the short term curative effects and chemotherapy side effects and to compare the survival of the two groups so that explore the clinical value of intraperitoneal hyperthermic perfusion chemotherapy in advanced epithelial ovarian cancer.2.Statistical methods:We adopted SPSS 17.0 statistical software for analyze,using mean±standard deviation(?x±s)represent for measurement data and t test for analysis.Count data adopted χ2 test or Fisher’s exact test represent for statistical data analysis.Chemotherapy toxicity was analyzed by rank sum test.Survival curve and single factor analysis were performed by Kaplan-Meier method.Cox proportional hazards regression model was used for multivariate analysis.Log-rank test survival difference,P <0.05 was statistically significant.Results1.In the 74 cases of III-IVstage ovarian epithelial cancer patients,the experiment group of 35 patients received intraperitoneal hyperthermic chemotherapy with 5-fluorouracil and carboplatin after cytoreductive surgery combined with intravenous chemotherapy and the control group of 39 patients used intravenous chemotherapy after cytoreductive surgery,both groups showed no statistically significant differences in age,pathological type,clinical stage,residual lesions(P>0.05).2.The CA125 descent rates between experiment group and control group(91.43% vs 79.49%)showed statistically significant differences(P<0.05).The ascites remission rates between two groups(97.14% vs 84.62%)showed statistically significant differences(P<0.05).3.Two groups with common adverse reactions for bone marrow suppression,liver and kidney damage,gastrointestinal toxicity,peripheral nerve toxicity,cardiovascular,experiment group had higher side effects in bone marrow suppression and gastrointestinal toxicity.4.The experimental group overall survival was significantly extended,the difference between the two groups was statistically significant.The experimental group and the control group 5-year survival rates were 42.86%,33.33% respectively.Conclusion1.The short-term effect of intraperitoneal hyperthermic perfusion chemotherapy combined with intravenous chemotherapy in clinical epithelial carcinoma is more obvious than intravenous group,which can effectively control ascites,improve clinical remission rate.significantly higher than that in intravenous group。2.Intraperitoneal hyperthermic perfusion chemotherapy combined with intravenous chemotherapy has higher bone marrow suppression and gastrointestinal toxicity than control group.It is safe and feasible.3.Intraperitoneal hyperthermic perfusion chemotherapy combined with intravenous chemotherapy can prolong the median overall survival of the patient and increase the 5-year survival rate. |
