铜绿假单胞注射液和顺铂治疗结直肠癌恶性腹腔积液的疗效对比
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摘要
目的回顾性分析甘露糖敏感性血凝菌毛的铜绿假单胞菌(PA-MSHA)制剂与顺铂在治疗结直肠癌恶性腹腔积液的近期疗效和安全性。方法回顾性分析就诊于河北医科大学第四医院的腹部B超证实为中-大量腹腔积液,且经细胞学检查为恶性腹腔积液的结直肠癌患者49例。根据治疗方案的选择分为2组,铜绿组(31人)和顺铂组(18人)。铜绿组:腹腔注射铜绿假单胞注射液10 mL×10支,第1、3、5天给药,7天一个周期,共2个周期;顺铂组:腹腔注射顺铂50 mg/m2,d1,7天为1个周期,共2个周期。两组同时期内给予mFOLFOX6方案化疗。参照WHO(1981)制定的腹腔积液治疗标准进行疗效评价;参考Karnofsky评分对患者生活质量进行评价;评估治疗过程中出现的不良反应。结果铜绿组31例中19例患者有效,顺铂组18例患者中5例有效(χ~2=5.118,P=0.024)。铜绿组31例患者中22例生活质量明显改善,顺铂组18例患者中7例患者生活质量明显改善(χ~2=6.586,P=0.01)。铜绿组中有12例(38.71%)患者出现发热,顺铂组中有2例(11.11%)患者出现发热(χ~2=4.25,P=0.039);铜绿组中有1例(3.23%)腹痛患者,而顺铂组中有6例(33.33%)患者出现腹痛(χ~2=8.43,P=0.004);铜绿组未出现腹腔感染,顺铂组中有2例(11.11%)患者出现腹腔感染(χ~2=3.591,P=0.058)。结论腹腔灌注铜绿假单胞注射液在治疗结直肠癌恶性腹腔积液是一种安全、有效的治疗方案,能取得较好的近期疗效,并能改善患者生活质量,且疗效优于顺铂。
Objective Retrospective analysis to investigate the short-term curative effect and safety of pseudomonas aeruginosa-mannosesensitive hemagglutinin(PA-MSHA) and cisplatin in the treatment of malignant ascites of colorectal cancer. Methods A retrospective analysis was made on 49 patients with colorectal cancer whose abdominal B-mode ultrasonography proved to be moderate to large amount of peritoneal effusion and malignant ascites by cytological examination in the Fourth Hospital of Hebei Medical University. There are 31 patients in the PA-MSHA group and 18 patients in the cisplatin group. PA-MSHA: Intraperitoneally inject PA-MSHA 10 mL×10 in the first, third, and fifth day, 7 days a cycle, 2 cycles in total. Cisplatin group: Intraperitoneally inject cisplatin 50 mg/m2 in the first day, 7 days a cycle, 2 cycles in total. The two groups were given mFOLFOX6 chemotherapy at the same time. The short-term efficacy was evaluated according to the WHO(1981) treatment criteria for malignant ascites. The quality of life was evaluated according to the Karnofsky score, and the adverse reactions during the treatment were evaluated. Results Among 31 cases in the PA-MSHA group, 19 cases were effective. Five cases in the cisplatin group were effective among 18 cases(χ~2=5.118, P=0.024). The quality of life(QOL) of 22 patients were obviously improved in the PA-MSHA group, while 7 cases in the cisplatin group(χ~2=6.586, P=0.01). The rate of fever is 38.71% in the PA-MSHA group and 11.11%(χ~2=4.25, P=0.039) in the cisplatin group. There was 1 case(3.23%) of abdominal pain in the PA-MSHA group, six cases(33.33%)in the cisplatin group(χ~2=8.43, P=0.004). There was no abdominal infection in the PA-MSHA group, and 2 cases(11.11%) of abdominal infection in the cisplatin group(χ~2=3.591, P=0.058). Conclusion Intraperitoneal infusion of PA-MSHA is a safe and effective treatment for malignant ascites of colorectal cancer. It can achieve good short-term effect and improve the quality of life of patients. The effective rate in the PA-MSHA group is significantly higher than that in the cisplatin group.
Objective Retrospective analysis to investigate the short-term curative effect and safety of pseudomonas aeruginosa-mannosesensitive hemagglutinin(PA-MSHA) and cisplatin in the treatment of malignant ascites of colorectal cancer. Methods A retrospective analysis was made on 49 patients with colorectal cancer whose abdominal B-mode ultrasonography proved to be moderate to large amount of peritoneal effusion and malignant ascites by cytological examination in the Fourth Hospital of Hebei Medical University. There are 31 patients in the PA-MSHA group and 18 patients in the cisplatin group. PA-MSHA: Intraperitoneally inject PA-MSHA 10 mL×10 in the first, third, and fifth day, 7 days a cycle, 2 cycles in total. Cisplatin group: Intraperitoneally inject cisplatin 50 mg/m2 in the first day, 7 days a cycle, 2 cycles in total. The two groups were given mFOLFOX6 chemotherapy at the same time. The short-term efficacy was evaluated according to the WHO(1981) treatment criteria for malignant ascites. The quality of life was evaluated according to the Karnofsky score, and the adverse reactions during the treatment were evaluated. Results Among 31 cases in the PA-MSHA group, 19 cases were effective. Five cases in the cisplatin group were effective among 18 cases(χ~2=5.118, P=0.024). The quality of life(QOL) of 22 patients were obviously improved in the PA-MSHA group, while 7 cases in the cisplatin group(χ~2=6.586, P=0.01). The rate of fever is 38.71% in the PA-MSHA group and 11.11%(χ~2=4.25, P=0.039) in the cisplatin group. There was 1 case(3.23%) of abdominal pain in the PA-MSHA group, six cases(33.33%)in the cisplatin group(χ~2=8.43, P=0.004). There was no abdominal infection in the PA-MSHA group, and 2 cases(11.11%) of abdominal infection in the cisplatin group(χ~2=3.591, P=0.058). Conclusion Intraperitoneal infusion of PA-MSHA is a safe and effective treatment for malignant ascites of colorectal cancer. It can achieve good short-term effect and improve the quality of life of patients. The effective rate in the PA-MSHA group is significantly higher than that in the cisplatin group.
引文
[1]Siegel R,Naishandham D,Jemal A.Cancer statistics,2013[J].CACancer J Clin,2013,63(1):11-30.
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[4]王浦华,沈通一,葛海燕.铜绿假单胞菌制剂在恶性肿瘤中的辅助治疗作用[J].世界华人消化杂志,2010,18(30):3171-3174.
[5]宋飞雪,裴霞霞,金七妹,等.铜绿假单胞菌注射液在恶性胸腔积液治疗中的疗效观察[J].中国肿瘤临床,2013,40(18):1127-1129.
[6]Teo M.Peritoneal-based malignancies and their treatment[J].Ann Acad Med Singapore,2010,39:54-57.
[7]Storni F,Stirnimann G,Banz V,et al.Treatment of Malignant Ascites Using an Automated Pump Device[J].Am J Gastroenterol,2018,113(7):1060-1061.
[8]Xia LJ,Wu YL,Ma J,et al.Therapeutic effects of antimicrobial peptide on malignant ascites in a mouse model[J].Mol Med Rep,2018,17(5):6245-6252.
[9]Hanada R,Yokomichi N,Kato C,et al.Efficacy and safety of reinfusion of concentrated ascitic fluid for malignant ascites:a concept-proof study[J].Support Care Cancer,2018,26(5):1489-1497.
[10]Elias D,Mariani A,Cloutier AS,et al.Modified selection criteria for complete cytoreductive surgery plus HIPEC based on peritoneal cancer index and small bowel involvement for peritoneal carcinomatosis of colorectal origin[J].Eur J Surg Oncol,2014,40(11):1467-1473.
[11]Zitvogel L,Ma Y,Raoult D,et al.The microbiome in cancer immunotherapy:Diagnostic tools and therapeutic strategies[J].Science,2018,359(6382):1366-1370.
[12]Galluzzi L,Chan TA,Kroemer G,et al.The hallmarks of successful anticancer immunotherapy[J].Sci Transl Med,2018,10(459):eeat7807.
[13]Uzbeck MH,Almeida FA,Sarkiss MG,et al.Management of Malignant Pleural Effusions[J].Adv Ther,2010,27(6):334-347.
[14]Zhang C,Zhang Z,Wang L,et al.Pseudomonas aeruginosa-mannose sensitive hemagglutinin injection treated cytokine-induced killer cells combined with chemotherapy in the treatment of malignancies[J].Int Immunopharmacol,2017,51:57-65.
[15]Mu XY.Success in establishing the MSHA-positive Pseudomonas aeruginosa fimbrial strain[J].J Microbiol,1986,26(2):176-179.
[16]Lavoie EG,Wangdi T,Kazmierczak BI.Innate immune responses to Pseudomonas aeruginosa infection[J].Microbes Infect,2011,13(14-15):1133-1145.
[17]Cai C,Chen W,Miao D,et al.Toll-like receptor 4 is required for the cytotoxicity of cytokine-induced killer cells[J].Acta Haematol,2014,132(1):5-9.
[18]Liu ZB,Hou YF,Min-Dong,et al.PA-MSHA inhibits proliferation and induces apoptosis through the up-regulation and activation of caspases in the human breast cancer cell lines[J].J Cell Biochem,2009,108(1):195-206.
[19]Xu WH,Liu ZB,Hou YF,et al.Inhibition of autophagy enhances the cytotoxic effect of PA-MSHA in breast cancer[J].BMC Cancer,2014,14:273.
[20]Wei Y,Liu D,Jin X,et al.PA-MSHA inhibits the growth of doxorubicin-resistant MCF-7/ADR human breast cancer cells by downregulating Nrf2/p62[J].Cancer Med,5(12):3520-3531.
[21]Liu J,Duan X.PA-MSHA induces apoptosis and suppresses metastasis by tumor associated macrophages in bladder cancer cells[J].Cancer Cell Int,2017,17:76.
[22]Li T,Dong ZR,Guo ZY,et al.Mannose-mediated inhibitory effects of PA-MSHA on invasion and metastasis of hepatocellular carcinoma via EGFR/Akt/IκBβ/NF-κB pathway[J].Liver Int,2015,35(4):1416-1429.
[23]Li Z,Hao D,Zhang H,et al.A clinical study on PA-MSHA vaccine used for adjuvant therapy of lymphoma and lung cancer[J].J West China Univ Med Sci,2000,31(3):334-337.
[24]沈娣,王腾,杭晓声,等.铜绿假单胞菌注射液联合化疗治疗晚期胃癌的临床观察[J].中南药学,2011,9(7):548-551.
[2]Torre A,Bray F,Siegel RL,et al.Global cancer statistics,2012[J].CACancer J Clin,2015,65(2):87-108.
[3]万莉,何耿劲.铜绿假单胞注射液治疗恶性胸腔积液的临床观察[J].临床肺科杂志,2013,18(3):401-402.
[4]王浦华,沈通一,葛海燕.铜绿假单胞菌制剂在恶性肿瘤中的辅助治疗作用[J].世界华人消化杂志,2010,18(30):3171-3174.
[5]宋飞雪,裴霞霞,金七妹,等.铜绿假单胞菌注射液在恶性胸腔积液治疗中的疗效观察[J].中国肿瘤临床,2013,40(18):1127-1129.
[6]Teo M.Peritoneal-based malignancies and their treatment[J].Ann Acad Med Singapore,2010,39:54-57.
[7]Storni F,Stirnimann G,Banz V,et al.Treatment of Malignant Ascites Using an Automated Pump Device[J].Am J Gastroenterol,2018,113(7):1060-1061.
[8]Xia LJ,Wu YL,Ma J,et al.Therapeutic effects of antimicrobial peptide on malignant ascites in a mouse model[J].Mol Med Rep,2018,17(5):6245-6252.
[9]Hanada R,Yokomichi N,Kato C,et al.Efficacy and safety of reinfusion of concentrated ascitic fluid for malignant ascites:a concept-proof study[J].Support Care Cancer,2018,26(5):1489-1497.
[10]Elias D,Mariani A,Cloutier AS,et al.Modified selection criteria for complete cytoreductive surgery plus HIPEC based on peritoneal cancer index and small bowel involvement for peritoneal carcinomatosis of colorectal origin[J].Eur J Surg Oncol,2014,40(11):1467-1473.
[11]Zitvogel L,Ma Y,Raoult D,et al.The microbiome in cancer immunotherapy:Diagnostic tools and therapeutic strategies[J].Science,2018,359(6382):1366-1370.
[12]Galluzzi L,Chan TA,Kroemer G,et al.The hallmarks of successful anticancer immunotherapy[J].Sci Transl Med,2018,10(459):eeat7807.
[13]Uzbeck MH,Almeida FA,Sarkiss MG,et al.Management of Malignant Pleural Effusions[J].Adv Ther,2010,27(6):334-347.
[14]Zhang C,Zhang Z,Wang L,et al.Pseudomonas aeruginosa-mannose sensitive hemagglutinin injection treated cytokine-induced killer cells combined with chemotherapy in the treatment of malignancies[J].Int Immunopharmacol,2017,51:57-65.
[15]Mu XY.Success in establishing the MSHA-positive Pseudomonas aeruginosa fimbrial strain[J].J Microbiol,1986,26(2):176-179.
[16]Lavoie EG,Wangdi T,Kazmierczak BI.Innate immune responses to Pseudomonas aeruginosa infection[J].Microbes Infect,2011,13(14-15):1133-1145.
[17]Cai C,Chen W,Miao D,et al.Toll-like receptor 4 is required for the cytotoxicity of cytokine-induced killer cells[J].Acta Haematol,2014,132(1):5-9.
[18]Liu ZB,Hou YF,Min-Dong,et al.PA-MSHA inhibits proliferation and induces apoptosis through the up-regulation and activation of caspases in the human breast cancer cell lines[J].J Cell Biochem,2009,108(1):195-206.
[19]Xu WH,Liu ZB,Hou YF,et al.Inhibition of autophagy enhances the cytotoxic effect of PA-MSHA in breast cancer[J].BMC Cancer,2014,14:273.
[20]Wei Y,Liu D,Jin X,et al.PA-MSHA inhibits the growth of doxorubicin-resistant MCF-7/ADR human breast cancer cells by downregulating Nrf2/p62[J].Cancer Med,5(12):3520-3531.
[21]Liu J,Duan X.PA-MSHA induces apoptosis and suppresses metastasis by tumor associated macrophages in bladder cancer cells[J].Cancer Cell Int,2017,17:76.
[22]Li T,Dong ZR,Guo ZY,et al.Mannose-mediated inhibitory effects of PA-MSHA on invasion and metastasis of hepatocellular carcinoma via EGFR/Akt/IκBβ/NF-κB pathway[J].Liver Int,2015,35(4):1416-1429.
[23]Li Z,Hao D,Zhang H,et al.A clinical study on PA-MSHA vaccine used for adjuvant therapy of lymphoma and lung cancer[J].J West China Univ Med Sci,2000,31(3):334-337.
[24]沈娣,王腾,杭晓声,等.铜绿假单胞菌注射液联合化疗治疗晚期胃癌的临床观察[J].中南药学,2011,9(7):548-551.