顺铂腹腔热灌注化疗联合静脉化疗治疗晚期上皮性卵巢癌的疗效分析OA

Objective To evaluate the clinical value of cisplatin-based hyperthermic intraperitoneal chemotherapy(HIPEC)combined with intravenous chemotherapy in the treatment of advanced epithelial ovarian cancer(EOC),focusing on its effects on serum tumor markers,immune checkpoint molecules,and immunomodulation.Methods A total of 60 patients with advanced EOC who were admitted to the Department of Gynecology,the First Hospital of China Medical University,between January 2021 and December 2025 were enrolled and divided into the study(n=15)and control(n=45)groups according to treatment regimens.The study group received cytoreductive surgery+cisplatin-based HIPEC+paclitaxel combined with carboplatin chemotherapy,whereas the control group received cytoreductive surgery+paclitaxel combined with carboplatin chemotherapy.The objective response rate(ORR)was compared between the two groups.Serum levels of cancer antigen 12-5(CA12-5),human epididymis protein 4(HE4),soluble programmed death-ligand 1(sPD-L1),soluble T-cell immunoglobulin and mucin-domain containing-3(sTIM-3),and T lymphocyte subsets(CD3+,CD4+,and CD8+T cells,as well as the CD4+/CD8+T cell ratio)were measured before and after treatment.In addition,the 2-year overall survival rate and incidence of treat-ment-related adverse reactions were compared to evaluate survival benefits and safety.Results The ORR in the study group was signif-icantly higher than that in the control group[93.33%(14/15)vs.82.22%(37/45),P=0.019].After treatment,serum levels of CA12-5,HE4,sPD-L1,and sTIM-3 decreased significantly in both groups compared with those before treatment(P<0.05),and the decreases in all indicators were significantly greater in the study group than in the control group(P<0.05).After treatment,the percentages of CD3+and CD4+T cells and the CD4+/CD8+T cell ratio increased in both groups,whereas the percentage of CD8+T cells decreased;the improve-ments in these indicators were significantly better in the study group than in the control group(P<0.05).The 2-year overall survival rate was 100%in the study group compared with 86.67%in the control group;however,this difference was not statistically significant(P>0.05).In terms of safety,no statistically significant difference was observed in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Cisplatin-based HIPEC combined with intravenous chemotherapy can significantly improve the treatment response rate in patients with advanced EOC and effectively reduce tumor burden.The combined regimen exhibits a trend toward improved 2-year overall survival without increasing the risk of severe adverse reactions.The mechanism may be related to the downregulation of immuno-suppressive molecules such as sPD-L1 and sTIM-3,improvement of T lymphocyte subset distribution,and immunomodulation.This com-bined regimen is safe and feasible,with promising clinical application prospects.