Clinical Research On Effect And Safety Of Celiac Continued Circulatory Hyperthermia Perfusion With Chemotherapy In The Treatment Of Cancer With Ascites

Objective: To evaluate the effect and safety of celiac continued circulatory hyperthermia perfusion with chemotherapy in cancer patients with ascites.Including short-term effect(objective response rate, disease control rate), improving the quality of life(Karnofsky score, EORCT QLQ-C30 quality of life score), long-term effect(2- year survival rate,ascites progression free survival) and safety, This treatment can provides clinical methods and reliable theoretical data for the malignant ascites.Methods: The open,non-randomized controlled trial, 200 patients were assigned to the experimental group(Celiac Continued C irculatory Hyperthermia Perfusion, CCCHP) and control group(Intraperitoneal C hemotherapy, IPC). All patients were hospitalized in our center, have evidence of pathology or cytology for malignant ascites, 78 cases in the control group of 100 patients have been followed up the past five years in the center. By balanced examination and all patients receiving topical treatment while receiving systemic chemotherapy, the total of four cycles. Evaluation of efficacy before the first cycle and the third cycle and after 4 weeks, efficacy index refers to short-term efficacy, improved quality of life, long-term efficacy and adverse reactions. Evaluation of malignant ascites by WHO on the evaluation criteria;the Karnofsky score and EORCT QLQ-C30 quality of life scores were used evaluate quality of life; the National Cancer Institute Common toxicity of anticancer drugs and grading criteria(NCI-CTC) version 3.0 was evaluated adverse reactions.Results: 200 cases of malignant ascites in patients, baseline balance test no difference before treatment(P > 0.05) perfusion group(100 cases) and non-perfusion group(100 cases) treatment objective response rate(ORR) was 65% and 47%(P = 0.01), disease control rate(DCR) was 85% and 73%(P = 0.037).O n the quality of life EORCT-QLQ C 3.0 scores showed that the physical function score(P=0.042), overall health(P = 0.039), pain(P = 0.022), shortness of breath(P = 0.03), insomnia(P = 0.025), appetite loss(P = 0.004) and constipation(P = 0.04) were better than non-perfusion group. But the experimental group patients showed the more economic difficulties(P = 0.026). The hyperthermia perfusion group better than the non- hyperthermia perfusion group about karnofsky score(χ2= 5.172, P= 0.023). Two groups of patients with a median disease- free survival of Show: gastric cancer(P= 0.018), ovarian cancer(P= 0.032), colorectal cancer(P= 0.042) in the experimental group progression- free time long than the control group, but the hepatoma showed no advantage in progression-free survival(P= 0.645),and 2-year cumulative survival rate of the two groups was no significant difference(P> 0.05). The incidence of adverse reactions were no statistically significant difference between the CCCHP and IPC(P> 0.05), the experimental group showed a small number of minor chemical peritonitis, but tolerable.Conclusion: Celiac Continued C irculatory Hyperthermia Perfusion with chemotherapy treatment cycle for malignant ascites in patients had better efficacy and safety, and can increase to gastric cancer 、 ovarian cancer 、 colorectal cancer ’s progression-free time, but it is not found in the hepatoma, there is no prolong progression-free survival, and is not different between the two groups about the 2- year survival.