腹腔循环热灌注联合化疗治疗晚期胃癌的临床研究  

Clinical research on hyperthermia pefusion cycle of abdominal space with chemotherapy in the treatment of advanced gastric carcinoma

作　　者：张晓飞[1] 刘文超[1] 喻召才[1] 杨静悦[1] 刘都户[1] 孙娟华[1] 张引亮[1] 

机构地区：[1]第四军医大学西京医院肿瘤中心,陕西西安710032

出　　处：《现代肿瘤医学》2010年第12期2415-2419,共5页Journal of Modern Oncology

基　　金：国家自然科学基金资助项目(30973473)

摘　　要：目的:观察腹腔循环热灌注联合化疗治疗晚期胃癌的有效性和安全性。方法:单纯接受化疗者采用DCF方案[多西他赛(DXT)、顺铂(CDDP)、5-氟尿嘧啶(5-FU)]56例,采用ECF方案[表阿霉素(EPI)、CDDP、5-FU]65例。腹腔循环热灌注联合化疗者,分别将DCF和ECF方案中CDDP经腹腔给药,其余药物经静脉给予,同时进行腹腔循环热灌注治疗,DCF方案56例,ECF方案64例。结果:腹腔循环热灌注联合化疗者(120例)与单纯化疗者(121)治疗有效率分别为68.3%和48.8%(P<0.01),临床获益率分别为92.5%和72.7%(P<0.01);其中腹水控制有效率,联合治疗者(76例)与单纯化疗者(74例)分别为65.8%和48.6%(P<0.05)。治疗后两组KPS评分提高率分别为58.3%和45.5%(P<0.05)。中位无进展生存期分别为9.8个月和7.7个月,中位总生存期分别为15.7个月和11.8个月,1年生存率分别为61.7%和48.8%(P<0.05)。Ⅱ-Ⅳ度血液学毒性及消化道不良反应二者相当(P>0.05),化学性腹膜炎联合化疗组略高(2例)(P>0.05)。结论:腹腔循环热灌注联合静脉化疗和单纯静脉化疗均是治疗晚期胃癌的有效方法,但腹腔循环热灌注联合静脉化疗显示出优越性并且安全。Objective：To evaluate the effect and safety of hyperthermia pefusion cycle of abdominal space with chemotherapy in patients with advanced gastric carcinoma.Methods：Fifty six advanced gastric cancer patients where enrolled who simply received DCF regimen,65 advanced gastric cancer patients who simply were received ECF regimen.Patients received hyperthermia pefusion cycle of abdominal space with chemotherapy was taken CDDP of DCF and ECF in abdominal space following hyperthermia perfusion cycle,the other medicine was taken by intravenous injection.Results：Overall response rates（CR ＋ PR） of combination chemotherapy（120 cases） and simply chemotherapy（121 cases） were respectively 68.3% and 48.8%（P 0.01）,disease control rates were respectively 92.5% and 72.7%（P 0.01）,peritoneal fluid control rate 65.8% and 48.6%（P 0.05）.Improving rates in KPS was 58.3% and 45.5%（P 0.05）.The median progress free survival（mPFS） was 9.8 and 7.7 months.The median overall survival（mOS） was 15.7 and 11.8 months.One-year survival rates were 61.7% and 48.8%（P 0.05）.The occurrence rate of Grade 2-4 in hematological toxicity and gastrointestinal adverse reactions was similar（P 0.05）.Chemical peritonitis in combination chemotherapy group was more a little（2 cases）（P 0.05）.Conclusion：Hyperthermia pefusion cycle of abdominal space with chemotherapy and simply chemotherapy are all effectual methods of advanced gastric carcinoma＇ therapy.But the former is more effectiver and is also safe in patients with advanced gastric carcinoma.

关 键 词：晚期胃癌 腹腔循环热灌注治疗 联合化疗 

分 类 号：R735.2[医药卫生—肿瘤]