两种方案治疗晚期胃癌恶性腹水的临床研究  

A Comparison on Two Medical Therapy in the Treatment on Maligrat Ascites Induced by Advanced Gastric Carcinoma

作　　者：陈春华[1,2] 刘明[1,2] 杜春[1,2] 张信来[1,2] 

机构地区：[1]内蒙古医学院附属医院消化科 [2]内蒙古医学院肿瘤外科,呼和浩特010050

出　　处：《临床消化病杂志》2010年第1期17-20,共4页Chinese Journal of Clinical Gastroenterology

摘　　要：目的观察比较植入用缓释氟尿嘧啶腹腔给药和腹腔内热灌注氟尿嘧啶化疗治疗晚期胃癌恶性腹水患者的近期疗效、临床获益反应及毒副反应。方法选择30例经病理组织学确诊的晚期胃腺癌腹水患者,随机分为两组,每组15例。植入用缓释氟尿嘧啶腹腔给药组:将按500mg/m2注入植入用缓释氟尿嘧啶,第14天再重复给药;热灌注化疗组:将5-FU1g溶于10%葡萄糖500ml中,加热至45℃,注入腹腔。第7天和第14天再重复给药。2周期治疗后评价疗效。结果植入用缓释氟尿嘧啶给药组和腹腔热灌注组总有效率分别为66.7%和64.2%,两组比较无显著性差异(P>0.05)。临床获益率分别为73.37%(11/15)和71.4%(10/14),两者比较无统计学差异(P>0.05)。血液系统毒性两组比较无统计学意义(P>0.05)。非血液系统毒性两组的腹泻、肾功能损害、周围神经炎、口腔黏膜炎的发生率无统计学差异(P>0.05);恶心/呕吐、肝功能损害的发生率有统计学差异(P<0.05)。结论两种方案治疗晚期胃癌恶性腹水疗效确切,均能显著改善患者的生活质量,两组对比无明显差异。毒副作用可以耐受,安全性好,但恶心/呕吐和肝功能损害的发生率在植入用缓释氟尿嘧啶腹腔给药组比腹腔内热灌注化疗组低。Objective To compare the implant with fluorouracil sustained-release drug delivery and intra-abdominal peritoneal perfusion heat fluorouracil chemotherapy for advanced gastric cancer and malignant ascites in patients o short-term efficacy,clinical benefit response and toxicity.Methods 30 cases with advanced gastric adenocarcinoma confirmed by histopathology of ascites were randomly divided into 2 groups,15 cases in each group.Intraperitoneal implantation of sustained-release drug delivery fluorouracil group：500 mg/m2 injected with sustained release fluorounracil,followed by repeat administration 14 days later.Perfusion chemotherapy group：the 5-FU 1 g dissolved in 500 ml 10% glucose,heated to 45℃,was infused into the abdominal cavity.The procednre was repeated 7 days and 14 day later.The patients were evalnated after 2 cycles.Results In these two groups,the total effective rate were 66.7% and 64.2%,no significant difference was noted（P0.05）.Clinical benefit rate was 73.37%（11/15） and 71.4%（10/14）,no significantly difference between the two groups（P0.05）.Hematological toxicity of the two groups was not different（P0.05）.Diarrhea,renal dysfunction injury,peripheral neuritis,the incidence of oral mucositis in the two groups were not significantly different（P0.05）;nausea/vomiting,liver dysfunction injury had a significant difference（P0.05）.Conclusion Both the treatment advanced malignant ascites in gastric cancer is effective,which can significantly improve the quality of life.These two treatment were safety and the side effects were tolerable,nausea/vomiting and liver dysfunction injury incidence in peritoneal implantation of sustained-release treatment group is lower than the fluorouracil heat peritoneal perfusion chemotherapy group.

关 键 词：胃癌恶性腹水 氟尿嘧啶缓释剂 体腔热灌注化疗 

分 类 号：R735.2[医药卫生—肿瘤]