体外循环全身热灌注治疗恶性肿瘤的疗效及安全性评估(15)(1)VIP专享VIP免费

体外循环全身热灌注治疗恶性肿瘤的疗效及安全性评估关键词：体外循环全身热灌注治疗【摘要】目的评估体外循环全身热灌注（EWBH）治疗复发、转移性肿瘤的疗效及安全性，观察其对全身各主要组织器官的损伤情况。方法监测60例2002年6月～2004年6月EWBH联合化疗的各类复发、转移性肿瘤病人术中各测温点的温度及相应的血液成分、肝、肾等脏器功能指标的变化，观察EWBH的安全性及对各组织器官的损伤；选择同期相同肿瘤类型及其化疗方案的病人45例作为对照组，比较EWBH组与对照组的疗效。结果EWBH治疗复发、转移性肿瘤病人的有效率(CR+PR+SD)为72.6%，PD为27.4%，血液相关肿瘤指标下降率为72.6%，肿瘤疼痛缓解率70.2%，体重增加率50.0%，睡眠改善率56.7%，术后KPS评分提高66.1%。一年生存率51.2%，半年生存率80.4%，明显高于对照组(P＜0.05)。该疗法升控温平稳安全。结论EWBH过程是平稳安全的，不会造成患者重要组织器官的损害，对治疗肿瘤有其不可忽视的疗效。【关键词】体外循环全身热灌注治疗；化疗；恶性肿瘤；疗效；安全性Assessmentoftheeffectsandclinicalsafetyofthetreatmentofadvancedmalignanttumorwithextracorporealwholebodyhyperthermia【Abstract】ObjectiveToassaytheprimaryeffectsandclinicalsafetyofthetreatmentofadvancedmalignanttumorwithextracorporealwholebodyhyperthermia(EWBH)，andtoevaluatetheimpairmentofittothevitalorgansandtissues.Methods60patientsofadvancedmalignanttumorweretreatedwithEWBHandchemotherapyfromJune2002toJune2004，whilethecontrolgroup(n=45)withsamespectrumandsamestageoftumorsweretreatedwithsimilarchemotherapyalone.WeassayedtheprimaryeffectsofEWBHthroughcomparingwithcontrols.ThestabilityandsafetyofEWBHinmonitoringandcontrollingthebodytemperaturewereevaluatedbyreal-timetemperaturemeasurementaswellastheimpairmentsofvitalorgansandtissues，suchasbrain，liver，kidneyandlung，werebyexaminationfunctionalindexofbodyperipheralblood.Results(1)Theeffectiverate(CR+PR+SD)ofEWBHandchemotherapywas72.6%ontreatingadvancedmalignanttumor，PDwas27.4%，thedescentrateofindexconcerningtumor(asAFP，CER，CA199，CA242，CA125andsoon)was72.6%，therateofpainrelievewas70.2%，thepercentageofcases，wholebodyweighthadincreasedpost-EWBHafterfourweeks，reached50.0%，andthatofthoseappetiteadvancedwas76.5%，ofthosesleepimprovedwas56.7%.TheindexesofKarnofskywasincreased.66.1%.51.2%patientsalivewereoveroneyearand80.4%overhalfoneyear.Allofthemarebetterthancontrols(P＜0.05).(2)Althoughtherearesomeimpairmentonfunctionandtissuesinthevitalorgan，thedamageisvenialandreversible.(3)ThemethodofEWBHissteadilyandsafeonmonitoringandcontrollingbodytemperature.ConclusionEWBHcanmakesomereversibleimpairtothesomevitalorgansandtissues，thewholeprocedureissteadyandsafeasoneofhyperthermiatherapytothemalignanttumor.EWBHcanimprovethepatientslivequalityandprolongtheirlife.【Keywords】extracorporeal；wholebodyhyperthermia；chemotherapy；malignanttumor；effect；safety体外循环全身热灌注治疗(extracorporealwholebodyhyperthermia，EWBH)是肿瘤全身热疗的一种方法，近年来在国内外越来越受到重视，并在临床上取得了良好的治疗效果［1，2］。我院采用美国FCM的TEMETTM1000型体外循环全身热灌注治疗系统，对各类复发、转移性肿瘤病人进行全身热疗联合化疗，并分析其疗效和安全性。1资料与方法1.1一般资料自2002年6月～2004年6月，笔者对60例各类复发、转移性肿瘤患者进行EWBH共62例次，其中2例病人进行EWBH2次，余均为1次。所有病人行EWBH的同时加用相应化疗药物。男39例，女21例；平均年龄43.6±1.4岁，其中年龄最大76岁，最小26岁。其中结直肠癌11例，肝癌10例，肺癌8例，胃癌5例，胰腺癌4例，上颌窦癌4例，乳腺癌3例，肾癌3例，骨肉瘤2例，恶性神经鞘膜...