ABSTRACT
Objective:By observing the changes of hyperthermia on serum carbohydrate antigen 125(CA125),human epididymal protein 4(HE4),chitinase protein(YKL) and immune function index effects,to investigate its effect on cancerous ascites and its antitumor effect of cytoreductive surgery combined with intraperitoneal hyperthermic perfusion chemotherapy and in elderly patients with advanced ovarian cancer.Methods: A total of 72 elderly patients with advanced ovarian cancer were enrolled in the study.They were randomly divided into contrast treatment group and combined treatment group,36 cases in each group.The patients in contrast treatment group were treated with cytoreductive surgery combined with intraperitoneal hyperthermic perfusion chemotherapy.The combined treatment group was treated with partial radiofrequency hyperthermia on the basis of the treatment of the control group.The efficacy was evaluated after 2 courses.The changes of CA125,HE4 and YKL contents and T cell subsets were compared between the two groups before and after treatment,and the safety was evaluated.Results: There was no difference in the operation between the two groups.The total effective rate was 80.0% in combined treatment group,which was significantly better than 55.6% in contrast treatment group(χ2=5.175,P<0.01).The effective rate of ascites control was 80.6% in combined treatment group,which was significantly higher than that in contrast treatment group 52.4%(χ2=3.962,P<0.05).After treatment,the levels of CA125,HE4 and YKL in the two groups were significantly lower than those before treatment,and the decrease of the combined treatment group was more significant than contrast treatment group(P<0.05).After treatment,the levels of CD3+,CD4+,CD4+/CD8+in both groups were lower than those before treatment,CD8+was lower than that before treatment,and the improvement of the indexes in combined treatment group was more significant than contrast treatment group(P<0.05).There was no significant difference between the two groups in the adverse effects of bone marrow suppression,gastrointestinal reaction and liver and kidney dysfunction(P> 0.05).Conclusion: CRS combined with IPHC and hyperthermia can significantly improve the immunosuppression of ovarian cancer,reduce the level of CA125,HE4,YKL, improve clinical efficacy of elderly patients with advanced ovarian cancer.
ABSTRACT
ABSTRACT Cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) has emerged as a main comprehensive treatment of peritoneal malignancies. However, current data on the literature are very heterogeneous in terms of its technical particularities, which require some efforts to standardization of practices. In these setting, we present some early data from a pioneering clinical trial in Brazil (ClinicalTrials.gov Identifier: NCT02249013) to explore the dynamic relationships between flow rates and temperature parameters in the first cases of our study, which may help in selecting better technical parameters during HIPEC procedures.
RESUMO Cirurgia citorredutora avançada e quimioterapia intraperitoneal hipertérmica (i.e.: HIPEC, sigla em inglês) têm se consagrado como promissora abordagem terapêutica multidisciplinar para neoplasias malignas peritoneais. Contudo, dados da literatura corrente são muito heterogêneos em torno de muitos de seus aspectos técnicos, o que demanda algum esforço na busca por padronizações do procedimento. Neste sentido, são apresentados dados de um ensaio clínico pioneiro no Brasil (ClinicalTrials.gov Identifier: NCT02249013), relacionando parâmetros dinâmicos de taxas de fluxo e temperaturas de perfusão nos primeiros casos do estudo, o que pode ajudar na seleção de melhores parâmetros técnicos para procedimentos de HIPEC.