术前区域性动脉灌注化疗治疗进展期胃癌的临床研究  

Effects of preoperative regional intra-arterial infusion chemotherapy for patients with advanced gastric cancer

作　　者：郁丰荣[1] 曹晖[1] 卞育海[1] 陈治平[1] 吴志勇[1] 

机构地区：[1]上海交通大学医学院附属仁济医院普外科,上海200127

出　　处：《外科理论与实践》2008年第1期44-47,共4页Journal of Surgery Concepts & Practice

摘　　要：目的:探讨新辅助化疗中应用术前区域性动脉灌注化疗治疗进展期胃癌的临床疗效。方法:35例临床诊断Ⅱ期以上胃癌病人在手术前接受新辅助化疗,方案为:丝裂霉素C15mg/m2,顺铂60mg/m2,5-氟尿嘧啶1000mg/m2,经股动脉插管区域冲击化疗一次,6～9d后接受手术。同期收治的41例Ⅱ期以上进展期胃癌病人行常规手术治疗。比较观察新辅助化疗后肿瘤原发病灶的缓解情况、毒副反应及两组间的远期生存率变化。结果:新辅助化疗组35例全部完成术前区域性动脉化疗,毒性反应主要为胃肠道反应和骨髓抑制,均属可控范围内1～2级,其中29例(82.9%)病人获得根治性切除(R0切除),中位生存期26.6个月,1、3和5年生存率分别为68.6%、37.1%和14.3%。常规手术组41例中有28例(68.3%)获得R0切除,中位生存期为15.3个月,1、3和5年生存率分别为63.4%、19.5%和7.3%。结论:术前区域性动脉化疗耐受性良好;新辅助化疗有望提高进展期胃癌病人的远期疗效。Objective To evaluate the effects of 5-fluorouracil （5-FU）, mitomycin C（MMC） and cisplatin （CDDP） as the preoperative regional intra-arterial infusion chemotherapy in advanced gastric cancer （AGC）. Methods Thirty-five patients with clinical stage Ⅱ -Ⅳ gastric carcinoma were submitted to preoperative regional-arterial infusion chemotherapy. The regimen consisting of MMC 15 mg/m^2, cisplatin 60 mg/m^2 and 5-FU 1 000 mg/m^2, was administrated 6-9 days before operation. Another forty-one patients withsimilar GC staging during the same period underwent surgery directly. The response of the primary tumor and chemotherapy toxicity were observed, together with the long term survival of the cases. Results All patients of the neoadjuvant chemotherapy group completed the planned regimen of chemotherapy and surgery successfully. The most common related adverse effects were grade 1-2 gastrointestinal discomfort and bone marrow depression. Twenty-nine cases（82.9%） underwent curative （R0） resection, the median survival time was 26.6 months, 1-,3-, and 5-year survival rates were 68.6%, 37.1% and 14.3%, respectively. Among the 41 patients undergoing surgery directly, 28 cases （68.3%） had R0 resection, the median survival time was 15.3 months, and 1-, 3-, and 5-year survival rates were 63.4%, 19.5% and 7,3%, respectively. Conclusions Neoadjuvant intra-arterial infusion chemotherapy has been welltolerated; it appears to have improved the prognosis of the AGC patients studied.

关 键 词：胃癌 新辅助化疗 动脉灌注 

分 类 号：R735.2[医药卫生—肿瘤]