| Objective: To investigate the safety,short-term efficacy and related factors of high-precision continuous hyperthermic intraperitoneal perfusion chemotherapy(HIPEC)after the operation of ovarian cancer.Methods:89 patients with epithelial ovarian cancer were divided into two groups.46 patients with HIPEC were in the research group,and they were combined with postoperative intravenous chemotherapy.In control group,43 patients were treated with intravenous chemotherapy alone.The efficacy and safety of the two groups were compared and analyzed.The vital signs,blood biochemistry,electrolyte fluctuations and other safety indicators of 46 patients with HIPEC were monitored in the treatment to analyze the factors affecting the times of perfusion.:1?There was no bone marrow suppression in the research group during the period of HIPEC.12 cases of side effects with grade I-II occurred in the course of intravenous chemotherapy(26.1%).There were 13 cases of side effects with grade III-IV(28.3%);In the control group,there were 17 cases of side effects with grade I-II(39.5%)and 10 cases of side effects with grade III-IV(23.3%)after intravenous chemotherapy.There was no significant difference between the two groups(z=0.354,P=0.723).The patients in the two groups did not appear poor healing of vaginal stump,intestinal fistula,infection,severe side effects of liver and kidney function damage.2?One month after operation,the CA125 negative rate was 45.7% in the research group(21/46)and 37.2% in the control group(16/43).X2(P)= 0.381(0.537).Three months after operation,the CA125 negative rate was 82.6% in the research group(38/46)and 65.1% in the control group(28/43),X2(P)= 0.917(0.338).The negative rate of research group was higher than that of control group,but there was no significant difference between the two groups(P>0.05);The median values of CA125 were obtained in all patients in the research group.It was 281.50U/ml before the operation and 50.75U/ml after the operation.z=5.053?P=0.001?P<0,05;The research group was divided into three groups according to the different perfusion times.After operation,only 14 patients were treated with HIPEC for once,6 patients were treated for twice and a total of 26 patients completed the treatment for three times.The median values of preoperative CA125 were 230.10U/ml?209.70U/ml?324.45U/ml.After completing the HIPEC treatment,the median values of CA125 were 52.65U/ml?47.75U/ml?43.852U/ml,z=0.001?0.046?0.001,P<0.05.Therefore,although the times of perfusion were different,the descent differences in the patients of the three groups were significant,and the HIPEC treatment was effective.3.Factors affecting the HIPEC implementation:46 cases were treated with HIPEC and their vital signs,blood biochemistry and electrolyte fluctuations were monitored in the treatment.56.5%(26/46)of them completed for three times,13.0%(6/46)of them completed for twice;30.4%(14/46)of them only completed for once.The incidence of hypokalemia occurred during the treatment was 8.7%(9/104).The incidence of hypoproteinemia was 28.8%(30/104).However,they did not affect the successful implementation of hyperthermic intraperitoneal perfusion.42.9%(6/14)of them only completed for once due to economic reasons.7.14%(1/14)and 28.6%(4/14)of them did not complete the treatment due to hypokalemia and hypoproteinemia respectively.In the patients who completed the HIPEC treatment for twice,16.7%(1/6)of them stopped the subsequent hyperthermic perfusion therapy due to hypoproteinemia and 50%(3/6)of them stopped due to hypokalemia.All patients were recovered after treated with oral or intravenous potassium and albumin.In the course of treatment,there were no serious adverse reactions.Conclusion:The effect of HIPEC is better than that of intravenous chemotherapy alone in the treatment of ovarian cancer.It is safe,effective,tolerable,and with less side effects.In this set of data,the economic reasons are the main factors affecting the implementation of HIPEC. |
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