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目的探讨体外药敏试验指导下对晚期肿瘤进行腹腔化疗的可行性及效果。方法分离51例恶性肿瘤患者腹水中的肿瘤细胞,MTT法测定肿瘤细胞对化疗药物的敏感性,选择对肿瘤细胞抑制率最高或次高的一种化疗药物进行腹腔化疗,观察药敏结果与癌性腹水疗效的一致性,及其与临床病例特征、KPS评分和预后的关系。结果MTT法显示TXT和HCPT是最敏感的化疗药物,而HCPT用于腹腔化疗最多(56．9%)。全组共有24例患者癌性腹水治疗有效(CR 7例,PR 17例),药敏结果与癌性腹水疗效之问存在低度一致性(P=0．014),癌性腹水有效组的行为状态评分(KPS)改善程度明显优于无效组(P＜0．001)。癌性腹水治疗是否有效,系本组患者的独立预后因素(P= 0．035)。结论MTT法药敏试验指导下腹腔化疗是一种简便、有效、安全的方法,癌性腹水治疗有效者的KPS及预后可明显改善。
Objective To investigate the feasibility and effect of intraperitoneal chemotherapy under the guidance of drug sensitivity test in vitro. Methods Tumor cells were isolated from ascites of 51 patients with malignant tumor. MTT assay was used to determine the sensitivity of the tumor cells to chemotherapeutic drugs. One chemotherapeutic agent with the highest or the lowest inhibitory rate of tumor cells was selected for intraperitoneal chemotherapy. Ascites efficacy of consistency, and its clinical features, KPS score and prognosis. Results MTT assay showed that TXT and HCPT were the most sensitive chemotherapeutic drugs, while HCPT was the most used for intraperitoneal chemotherapy (56.9%). A total of 24 patients with cancerous ascites were treated effectively (7 in CR and 17 in PR). There was a low concordance between susceptibility and cancerous ascites (P = 0.014) Performance status scores (KPS) improved significantly better than the invalid group (P <0.001). Cancerous ascites treatment is effective, the independent prognostic factor in this group of patients (P = 0.035). Conclusion MTT method under the guidance of drug sensitivity test under intraperitoneal chemotherapy is a simple, effective and safe method, effective treatment of cancerous ascites KPS and prognosis can be significantly improved.