2017 年第 10 期 第 12 卷

小剂量奈达铂每周腹腔灌注治疗恶性腹腔积液的效果及安全性

Effect and safety of low dose nedaplatin intraperitoneal perfusion chemotherapy on malignant ascites

作者：党受涛顾梅朱长雨赵京阳李志新

英文作者：Dang Shoutao Gu Mei Zhu Changyu Zhao Jingyang Li Zhixin

单位：100176首都医科大学附属北京同仁医院肿瘤科

英文单位：Department of Oncology Beijing Tongren Hospital Capital Medical University Beijing 100176 China

关键词：恶性腹腔积液；奈达铂；腹腔灌注

英文关键词：Malignantascites;Nedaplatin;Intraperitonealperfusion

• 摘要：

• 目的 探讨小剂量奈达铂每周腹腔灌注治疗恶性腹腔积液的效果及安全性。方法 选取2011年9月至2016年11月首都医科大学附属北京同仁医院肿瘤科腹腔积液病理确诊恶性腹腔积液患者17例为研究对象。在放净腹腔积液后，予奈达铂15 mg/m2、1次/周腹腔灌注化疗。于腹腔灌注后24 h，开放腹腔引流，每日放净腹腔积液。每次腹腔灌注治疗前复查超声了解腹腔分隔情况。灌注至8周疗程结束或患者腹腔积液完全消失或无法耐受进一步治疗或出现腹腔分隔。记录腹腔积液引流量并计算日均排放腹腔积液量，并根据日均腹腔积液引流量的变化评价疗效。记录腹腔灌注后24 h内腹痛发生情况及化疗相关全身不良反应情况。结果 17例患者共行腹腔灌注化疗111次，平均6.5次/例，其中完全缓解2例（11.8%），部分缓解5例（29.4%），稳定8例（47.1%），进展2例（11.8%）。腹腔灌注后24 h内腹痛的发生率为8.1%（9/111），腹腔分隔的发生率为35.3%（6/17）。所有患者均无3～4级化疗相关全身不良反应。结论 小剂量奈达铂每周灌注化疗是一种耐受性较好且有一定疗效的治疗恶性腹腔积液的方法。

• Objective To investigate the effect and safety of low dose nedaplatin intraperitoneal perfusion chemotherapy on patients with malignant ascites. Methods Seventeen patients with malignant ascites were enrolled from September 2011 to November 2016 in Beijing Tongren Hospital, Capital Medical University. They were treated with nedaplatin intraperitoneal perfusion 15 mg/m2, 1 time/week after complete ascites drainage following with daily ascites drainage 24 h after intraperitoneal perfusion. Abdominal ultrasonography was performed every week before intraperitoneal perfusion to examine abdominal cavity septation. The full course was 8 weeks; ascites disappearance, intolerance of treatment and occurrence of abdominal cavity septation were observed during therapy. Ascites drainage volume was recorded; the therapeutic effectiveness was determined by changes of ascites volume. Incidences of abdominal pain within 24 h after intraperitoneal perfusion and systemic side effects were recorded. Results Seventeen patients had 111 cycles of intraperitoneal perfusion in total; on average each patient had 6.5 cycles. There were 2 cases（11.8%） having complete response, 5 cases（29.4%） having partial response, 8 cases（47.1%） having stable disease and 2 cases（11.8%） having progressive disease. Incidences of 24 h abdominal pain and abdominal cavity septation were 8.1%（9/111） and 35.3%（6/17）, respectively. No patient had grade 3-4 chemotherapy-related systemic adverse reactions. Conclusion Low dose nedaplatin intraperitoneal perfusion per week is a safe and effective therapy for patients with malignant ascites.