【摘要】 目的 探讨腹腔热灌注化疗治疗妇科恶性肿瘤的疗效与安全性。方法 收集2020年3月至2021年3月97例术后接受腹腔热灌注化疗(HIPEC)的晚期及复发性妇科恶性肿瘤(卵巢癌、输卵管癌、腹膜癌、子宫内膜癌、肉瘤、宫颈癌)患者的一般资料。近期疗效根据实体肿瘤疗效评价标准(RECIST 1.1)进行评价，比较初治、新辅助化疗后及复发性卵巢癌的近期疗效，并对子宫内膜癌、肉瘤、宫颈癌患者的治疗疗效进行评估。比较HIPEC前后患者生活质量、不良反应、血清热休克蛋白90α、胸苷激酶1(TK1)、D-二聚体及体液免疫指标(Ig G、Ig M、Ig A)水平的变化。结果 在80例上皮性卵巢癌患者中，客观有效率(ORR)为68.8%(55/80)，疾病控制率(DCR)为80.0%(64/80)。初治组的ORR与DCR均略高于新辅助化疗组与复发组，但差异无统计学意义(P>0.05);铂耐药复发患者的ORR与DCR均略高于铂敏感复发者，但差异无统计学意义(P>0.05)。HIPEC后生活质量评分高于治疗前，差异有统计学意义(P<0.05);血清Ig G、Ig M、Ig A及TK1在HIPEC后的水平均低于HIPEC前，差异有统计学意义(P<0.05);血清热休克蛋白90α与D-二聚体水平在接受HIPEC后有所升高，差异有统计学意义(P<0.05)。97例患者发生的主要不良反应包括:疼痛、呼吸困难、腹胀、肠梗阻、恶心、呕吐、发热、血液毒性、乏力、血栓、感染、术口愈合不良、心血管意外及术后出血等，严重不良反应发生率为31.9%(31/97)。结论 HIPEC治疗晚期、复发性妇科恶性肿瘤的疗效及安全性较好，但仍需进一步临床研究。更多还原

【Abstract】 Objective To investigate the efficacy and safety of hyperthermic intraperitoneal chemotherapy( HIPEC) in gynecological malignant tumors. Methods We collected 97 patients with advanced and recurrent gynecological malignancies( ovarian cancer,fallopian tube cancer,peritoneal cancer,endometrial cancer,sarcoma and cervical cancer) who received HIPEC after surgery from March 2020 to March 2021. The short-term efficacy was evaluated according to response solid tumor efficacy evaluation standard( RECIST 1. 1). The short-term efficacy of HIPEC in upfront,neoadjuvant chemotherapy and recurrent ovarian cancer was evaluated and compared,and the efficacy of HIPEC in endometrial cancer,sarcoma and cervical cancer was summarized. The quality of life,morbidities,and the level of serum heat shock protein 90α,thymus kinase 1( TK1),D-dimer and humoral immune indexes( Ig G,Ig M,Ig A) were compared before and after HIPEC. Results In 80 cases of epithelial ovarian cancer patients,the objective response rate( ORR) was 68. 8%( 55/80),and the disease control rate( DCR) was 80. 0%( 64/80). The ORR and DCR of the upfront group were slightly higher than those of the neoadjuvant chemotherapy group and the recurrence group,but the difference was not statistically significant( P>0. 05). The ORR and DCR of patients with platinum resistant relapse were slightly higher than those of patients with platinum sensitive relapse,but the difference was not statistically significant( P> 0. 05). The quality of life score after HIPEC was higher than those before treatment,and the difference was statistically significant( P<0. 05). The levels of serum Ig G,Ig M,Ig A and TK1 after HIPEC were significantly lower than those before HIPEC( P< 0. 05). The levels of serum heat shock protein 90α and Ddimer increased after receiving HIPEC( P<0. 05). The major adverse events included pain,dyspnea,abdominal distention,intestinal obstruction,nausea,vomiting,fever,blood toxicity,fatigue,thrombosis,infection,poor healing of the operative site,cardiovascular accidents as well as postoperative bleeding,and the incidence of serious morbidities was 31. 9%( 31/97). Conclusion The efficacy and safety of HIPEC in the treatment of advanced and recurrent gynecologic malignant tumors are good,but further clinical research is still needed.更多还原