| | | 体外循环全身热灌注治疗恶性肿瘤的疗效及安全性评估
| | 超声医学论文侯凯生，金重华，高友福△，陈雪良
关键词：体外循环全身热灌注治疗
【摘要】 目的超声医学论文 评估体外循环全身热灌注（EWBH）治疗复发、转移性肿瘤的超声医学论文疗效及安全性，观察其对全身各主要组织器官的损伤情况。方法 监测60例2002年6月～2004年6月EWBH联合化疗的各类复发、转移性肿瘤病人术中各测温点的温度及相应的血液成分、肝、肾等脏器功能指标的变化，观察EWBH的安全性及对各组织器官的损伤；选择同期相同肿瘤类型及其化疗方案的病人45例作为对照组，比较EWBH组与对照组的疗效。结果 EWBH治疗复发、转移性肿瘤病人的有效率(CR+PR+SD)为72.6%，PD 为 27.4%，血液相关肿瘤指标下降率为72.6%，肿瘤疼痛缓解率70.2%，体重增加率50.0%，睡眠改善率56.7%，术后KPS评分提高66.1%。一年生存率51.2%，半年生存率80.4%，明显高于对照组(P＜0.05)。该疗法升控温平稳安全。结论 EWBH过程是平稳安全的，不会造成患者重要组织器官的损害，对治疗肿瘤有其不可忽视的疗效。
【关键词】 体外循环全身热灌注治疗；化疗；恶性肿瘤；疗效；安全性
Assessment of the effects and clinical safety of the treatment of advanced malignant tumor with extracorporeal whole body hyperthermia
【Abstract】 Objective To assay the primary effects and clinical safety of the treatment of advanced malignant tumor with extracorporeal whole body hyperthermia(EWBH)，and to evaluate the impairment of it to the vital organs and tissues.Methods 60 patients of advanced malignant tumor were treated with EWBH and chemotherapy from June 2002 to June 2004， while the control group (n=45) with same spectrum and same stage of tumors were treated with similar chemotherapy alone. We assayed the primary effects of EWBH through comparing with controls. The stability and safety of EWBH in monitoring and controlling the body temperature were evaluated by real-time temperature measurement as well as the impairments of vital organs and tissues， such as brain， liver， kidney and lung， were by examination functional index of body peripheral blood.Results (1) The effective rate (CR+PR+SD) of EWBH and chemotherapy was 72.6% on treating advanced malignant tumor， PD was 27.4%， the descent rate of index concerning tumor (as AFP， CER， CA199， CA242， CA125 and so on) was 72.6 %， the rate of pain relieve was 70.2%， the percentage of cases， whole body weight had increased post-EWBH after four weeks， reached 50.0%， and that of those appetite advanced was 76.5%， of those sleep improved was 56.7%. The indexes of Karnofsky was increased. 66.1%.51.2% patients alive were over one year and 80.4%over half one year. All of them are better than controls (P＜0.05). (2)Although there are some impairment on function and tissues in the vital organ， the damage is venial and reversible. (3) The method of EWBH is steadily and safe on monitoring and controlling body temperature.Conclusion EWBH can make some reversible impair to the some vital organs and tissues， the whole procedure is steady and safe as one of hyper thermia therapy to the malignant tumor. EWBH can improve the patients live quality and prolong their life.
【Key words】 extracorporeal；whole body hyperthermia；chemotherapy；malignant tumor；effect；safety
体外循环全身热灌注治疗(extracorporeal whole body hyperthermia，EWBH)是肿瘤全身热疗的一种方法，近年来在国内外越来越受到重视，并在临床上取得了良好的治疗效果［1，2］。我院采用美国FCM的TEMETTM1000型体外循环全身热灌注治疗系统，对各类复发、转移性肿瘤病人进行全身热疗联合化疗，并分析其疗效和安全性。
1 资料与方法
1.1 一般资料 自2002年6月～2004年6月，笔者对60例各类复发、转移性肿瘤患者进行EWBH共62例次，其中2例病人进行EWBH 2次，余均为1次。所有病人行EWBH的同时加用相应化疗药物。男39例，女21例；平均年龄43.6±1.4岁，其中年龄最大76岁，最小26岁。其中结直肠癌11例，肝癌10例，肺癌8例，胃癌5例，胰腺癌4例，上颌窦癌4例，乳腺癌3例，肾癌3例，骨肉瘤2例，恶性神经鞘膜瘤2例，胸腔恶性间皮瘤2例，卵巢癌1例，腹腔恶性间皮瘤1例，鼻咽癌1例，舌癌1例，左颚腺样囊性癌1例，纵隔神经母细胞瘤1例。选择同期相同肿瘤类型及其化疗方案的患者45例作为对照组。
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