腹腔热灌注化疗治疗晚期胃癌合并腹水的临床疗效观察  

The clinical efficacy of hyperthermic intraperitoneal chemotherapy for late-staged gastric cancer with malignant ascites

作　　者：唐鸿生[1] 崔书中[1] 唐云强[1] 巴眀臣 吴印兵[1] 张相良[1] 

机构地区：[1]广州医科大学附属肿瘤医院腹外科(体腔热灌注治疗中心),广州510095

出　　处：《消化肿瘤杂志（电子版）》2013年第1期26-32,共7页Journal of Digestive Oncology(Electronic Version)

基　　金：国家自然科学基金(81201932);广州医科大学博士启动基金(2012C66;2012C69);卫生部医药卫生科技发展研究中心(W2011WAI45)

摘　　要：目的探讨腹腔热灌注化疗(hyperthermic intraperitoneal chemotherapy,HIPEC)在晚期胃癌患者治疗中的作用及意义。方法回顾性分析2008年5月至2011年5月在本院开腹手术、腹腔镜和B超引导下置管行HIPEC的晚期胃癌患者24例,观察HIPEC治疗癌性腹水的临床效果及毒副反应,比较不同方式(开腹手术、腹腔镜辅助及B超引导下置管)行HIPEC对晚期胃癌患者的疗效差异。结果所有患者均顺利进行HIPEC,无严重的治疗相关并发症发生。治疗晚期胃癌恶性腹水的有效率达83.3%。患者的生活质量得到改善,治疗后2周的KPS评分明显升高,差异有统计学意义(P<0.01)。开腹手术HIPEC组患者的中位生存期为11.5个月,腹腔镜HIPEC组为9.0个月,B超引导下HIPEC组为12.0个月,三组间患者生存率比较差异无统计学意义(P>0.05)。结论 HIPEC对于晚期胃癌合并腹水的患者具有积极的治疗作用,能够有效治疗腹水、提高患者生活质量、延长生存期;HIPEC不同方式置管对晚期胃癌患者的生存期无明显影响。Objective To Investigate the role and effect of hyperthermic intraperitoneal chemotherapy(HIPEC) for late-staged gastric cancer with ascites. Methods Clinical data of 24 latestaged gastric cancer patients with malignant ascites undergoing HIPEC from May 2008 to May 2011 in our hospital were analyzed retrospectively. HIPEC was performed through open, laparoscopy assisted or ultrasound-guided methods. The efficacy and adverse events associated with HIPEC were observed, and the survival outcomes after HIPEC were analyzed. Results HIPEC was carried out successfully in all patients. There were no serious treatment-related complications. The total response rate of HIPEC for malignant ascites was 83.3%. KPS scores of the patients two weeks after treatment increased significantly(P<0.05). The quality of life was improved dramatically in all patients. The median survival time of the patients with open surgery, laparoscopic-assisted and ultrasound-guided HIPEC were 11.5, 9.0 and 12.0months respectively, with no statistical significance(P >0.05). Conclusions HIPEC is an ideal therapeutic approach for late-staged gastric cancer patients, which could control malignant ascites,improve the quality of life and prolong the survival time. There is no difference in survival time among open surgery, laparoscopic-assisted or ultrasound guided HIPEC.

关 键 词：晚期胃癌 腹腔热灌注化疗 疗效 

分 类 号：R735.2[医药卫生—肿瘤]