Clinical Observation Of Endostar Combined With Cisplatin And Cisplatin Hyperthermic Intraperitoneal Chemotherapy And Single Cisplatin In The Treatment Of Malignant Ascites

Objective: Compared Endostar combined with cisplatin intraperitoneal perfusion and cisplatin hyperthermic intraperitoneal chemotherapy and single cisplatin intraperitoneal perfusion,the three different kinds of malignant ascites treatment,to analyze curative effect,related adverse reaction and survival,in order to provide a certain basis for the clinical treatment of malignant ascites.Methods: 87 patients with malignant ascites,from department of Medical Oncology,the first affiliated hospital of Wannan Medical College and Huangshan City People’s Hospital,were collected from October,2013~ October,2015,and divided into Endostar combined with cisplatin intraperitoneal perfusion group(group A),cisplatin hyperthermic intraperitoneal chemotherapy group(group B)and single cisplatin intraperitoneal perfusion group(group C)by treatments to analysis.Group A of 35 cases,14 cases of male,female 21 cases,group B of 28 cases,17 were male,female in 11 cases,24 cases of group C,male 11 cases,13 cases of women.Diseases were mainly gastric cancer,colon cancer,ovarian cancer,and rectal cancer.All of the patients underwent abdominal puncture drainage after B ultrasonic positioning,and drainage of ascites as much as possible.In group A: Endostar 60 mg intraperitoneal injection everytime,combined with cisplatin 60 mg intraperitoneal injection everytime.In group B: cisplatin 60 mg and saline 2000 ml in thermostatic cycle used thermal circulation perfusion machine,treated for 90 minutes.In group C : intraperitoneal injection of cisplatin 60 mg everytime.For this three group,treatment used in day first and eighth of each course.The effect,adverse reaction and survival evaluated after a course.Result: All patients were accepted 1 courses of treatment.In group A,ascites in complete remission(CR)had 14 cases,partial response(PR)in 12 cases and the effective rate(RR)was 74.29%.In group B,complete remission(CR)and partial response(PR)were 10 cases and 12 cases respectively,and the effective rate(RR)was78.57%,and group C of ascites in patients with complete remission(CR)in 3 patients,partial response(PR)in 7 cases,the effective rate(RR)was 41.67%.Compared total effective rate in three groups,group A and group B had differences with group C and the differences were statistically significant(P < 0.0167),and between group A and group B,there was no statistical significance(P > 0.0167).After treatment,the symptom such as abdominal distension,abdominal pain,nausea,chest tightness was improved obviously,and the quality of life(QOL)improved obviously earlier.According to the comparative analysis of the KPS score before and after treatment,the quality of life of patients in group A improved in 24 cases(68.57%),and group B improved in 20 cases,improve rate was 71.42%,and in group C,9 patients improved(37.50%).Compared each groups,the improvement of quality of life is more obvious in group A and group B than in group C,the difference was statistically significant(P < 0.0167),and between group A and group B was found no statistical difference(P > 0.0167).Three groups of patients with adverse reaction were lighter.The mainly adverse reaction included bone marrow suppression,nausea,vomiting,fever and liver function damage,etc.After symptomatic treatment,patients’ symptoms were improved,no impact on the follow-up treatment.Comparison of adverse reaction between each group had no statistical significance(P > 0.05).In survival analysis of the three groups,patients’ time to progress(TTP)in group A was 20-179 days,the median time to progress(TTP)was 91 days,group B of 17-163 days,the median time to progress(TTP)was 80 days,and in group C of 6-89 days,median time to progress(TTP)was 37 days.Compared Group A and Group B with group C,respectively,time to progress(TTP)was extended obviously and the difference was statistically significant(P<0.0167).Conclusion: Endostar combined with cisplatin intraperitoneal perfusion chemotherapy and cisplatin hyperthermic intraperitoneal chemotherapy for malignant ascites has good curative effect and with good tolerance in patients and also prolonged the time to progress(TTP)of patients.Compared with single drug cisplatin intraperitoneal perfusion chemotherapy,patients had significant improved quality of life and lighter adverse reaction.The differences were statistically significant(P < 0.0167).In the treatment of Endostar combined with cisplatin intraperitoneal perfusion chemotherapy and cisplatin hyperthermic intraperitoneal chemotherapy of malignant ascites,there were not statistically differences in efficient,incidence of adverse reaction and the influence of quality of life(P > 0.0167),both the two treatments of malignant ascites had certain clinical significance.