Effects of TP regimen combined with intraperitoneal hyperthermic perfusion chemotherapy on immune function, quality of life and prognosis of patients with advanced ovarian cancer.

Abstract

Objective: To evaluate the effect of paclitaxel and cisplatin (TP regimen) combined with intraperitoneal hyperthermic perfusion chemotherapy on immune function and quality of life in patients with advanced ovarian cancer.

Methods: This retrospective study involved 107 patients with advanced ovarian cancer who were treated in Baoji Central Hospital between March 2016 and March 2020. The control group was treated with the TP regimen alone (n=48), while the observation group received additional intraperitoneal heat infusion chemotherapy containing 60 mg of cisplatin on the 8th day following the final chemotherapy (n=59). Immunoglobulin (IgG, IgA, IgM) levels, quality of life, tumor marker levels, incidence of adverse effects, and 3-year survival were compared between the two groups. Besides, factors affecting patients' prognosis were detected by unifactorial and multifactorial analyses.

Results: Before treatment, there was no significant difference between the two groups in terms of IgG, IgA, and IgM levels (all P>0.05). After treatment, the observation group showed significantly higher levels of IgG, IgA, and IgM than those in the control group (all P<0.05). There were no significant differences in pre-treatment Kamofsky (KPS) score, carcinoembryonic antigen (CEA), and carbohydrate antigen 125 (CA125) between the two groups (all P>0.05). However, after treatment, the KPS score was significantly increased in the observation group as compared to pre-treatment or control group (both P<0.05), while CEA and CA125 significantly decreased in the observation group as compared to pre-treatment or control group (all P<0.05). Nevertheless, the incidence of gastrointestinal reactions in the observation group was higher than that in the control group (P<0.05). The survival rate of the observation group was significantly higher than that of the control group (P<0.05). The AUC of post-treatment IgG for predicting 3-year survival of patients was 0.743. The 3-year survival rate of patients with IgG≥10.950 g/L was significantly higher than that of patients with IgG<10.950 g/L (P<0.05). Multifactorial Cox regression analysis revealed that higher FIGO stage, presence of ascites, higher post-treatment IgG level, and higher post-treatment CEA and CA125 levels were independent risk factors for patients' 3-year mortality.

Conclusion: TP regimen combined with intraperitoneal hyperthermic perfusion chemotherapy significantly improves immune function and quality of life in patients with advanced ovarian cancer, although it increases the incidence of gastrointestinal reactions. Higher FIGO stage, presence of ascites, higher IgG after treatment, higher CEA, and higher CA125 were independent risk factors for patients' 3-year mortality.