Ito Rikako, Kagabu Masahiro, Sato Sho, Takatori Eriko, Kaido Yoshitaka, Nagasawa Takayuki, Shoji Tadahiro, Hirayama Takashi, Terao Yasuhisa, Baba Tsukasa
Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, 2-1-1, Idaidori, Yahaba, Iwate, 028-3695, Japan.
Department of Obstetrics and Gynecology, Faculty of Medicine, Juntendo University, 3-1-3 Hongo, Bunkyo-ku, Tokyo, Japan.
Int J Clin Oncol. 2025 Mar;30(3):559-569. doi: 10.1007/s10147-024-02682-1. Epub 2025 Jan 4.
The quality of life (QOL) of ovarian cancer patients is often impaired by refractory ascites. Cell-free and concentrated ascites reinfusion therapy (CART) is a palliative treatment for refractory ascites, but adverse events, such as fever, are problematic. Several cytokines have been suggested to be responsible for the adverse events, but they have not been investigated in detail. Thus, we comprehensively analyzed cytokines in ascites fluid (AF) and serum before and after CART to determine the influence of cytokines on the safety and efficacy of CART.
Thirteen ovarian cancer patients with refractory malignant ascites who underwent CART were enrolled. We comprehensively analyzed 27 cytokines in AF and serum before and after CART. Simultaneously, vital measurements, blood tests, adverse event recordings, and QOL assessments were performed to examine the relationships between the cytokines in AF and serum.
Interleukin (IL)-5, IL-6, IL-10, and monocyte chemoattractant protein-1 levels were increased in the concentrated AF and in the serum immediately after reinfusion, but they decreased after 24 h. Body temperature also increased immediately after reinfusion, and decreased after 24 h. The CRP level at 24 h after reinfusion was increased, and was positively correlated with the IL-6 level. A QOL assessment using the Cancer Fatigue Scale revealed significantly lower scores after CART.
The results indicate that the cytokine-induced fever and increased inflammatory response after CART were temporary, and that CART is safe. Additionally, QOL improved after CART. Thus, CART appears safe and effective for treating patients with refractory cancerous ascites.
难治性腹水常损害卵巢癌患者的生活质量（QOL）。无细胞浓缩腹水回输疗法（CART）是一种治疗难治性腹水的姑息疗法，但诸如发热等不良事件是个问题。有几种细胞因子被认为与这些不良事件有关，但尚未进行详细研究。因此，我们全面分析了CART前后腹水液（AF）和血清中的细胞因子，以确定细胞因子对CART安全性和疗效的影响。
纳入13例接受CART治疗的难治性恶性腹水卵巢癌患者。我们全面分析了CART前后AF和血清中的27种细胞因子。同时，进行生命体征测量、血液检查、不良事件记录和QOL评估，以检查AF和血清中细胞因子之间的关系。
浓缩AF和回输后即刻血清中的白细胞介素（IL）-5、IL-6、IL-10和单核细胞趋化蛋白-1水平升高，但24小时后下降。回输后即刻体温也升高，24小时后下降。回输后24小时C反应蛋白（CRP）水平升高，且与IL-6水平呈正相关。使用癌症疲劳量表进行的QOL评估显示，CART后得分显著降低。
结果表明，CART后细胞因子诱导的发热和炎症反应增强是暂时的，且CART是安全的。此外，CART后QOL有所改善。因此，CART似乎对治疗难治性癌性腹水患者安全有效。
