进展期胃癌患者术后腹腔持续温热灌注化疗联合静脉化疗的疗效观察  

Postoperative Intraperitoneal Hyperthermia Chemoperfusion Combined with Intravenous Chemotherapy for Advanced Gastric Cancer Patients

作　　者：张峰[1] 刘国平[1] 刘畅[1] 刘晓军[2] 

机构地区：[1]复旦大学附属金山医院急诊科,上海200540 [2]上海第二军医大学,上海200433

出　　处：《中国临床医学》2011年第3期338-340,共3页Chinese Journal of Clinical Medicine

摘　　要：目的:观察进展期胃癌术后行腹腔持续温热灌注联合全身静脉化疗的临床疗效。方法:135例进展期胃癌术后患者随机分为治疗组和对照组。治疗组67例,行腹腔持续温热灌注联合全身静脉化疗4次,之后行常规静脉化疗;对照组68例,行常规静脉化疗12次;2组常规化疗均采用FOLFOX6方案,并均于术后4周开始常规化疗。结果:(1)治疗组1年、3年、5年生存率分别为95.38%、78.63%和58.47%;对照组分别为93.21%、67.95%和41.81%。2组1年生存率差异无统计学意义(P>0.05),3年、5年生存率差异有统计学意义(P<0.05);(2)治疗组卡氏评分法(KPS)评分升高率为59.70%,对照组为42.65%,2组KPS升高率比较差异有统计学意义(P<0.05);(3)治疗组腹腔局部复发率显著低于对照组(14.92%比30.88%,P<0.05),而远处转移率2组差异无统计学意义(32.84%比35.29%,P>0.05);(4)治疗不良反应主要为消化系统反应与造血系统抑制,但无一例因化疗不良反应而影响治疗。结论:腹腔持续温热灌注联合全身静脉化疗可降低化疗不良反应,延缓病情发展、改善生活质量,延长进展期胃癌术后患者的生存期。Objective：To evaluate the efficacy of postoperative intraperitoneal hyperthermia chemo perfusion（IHCP）combined with intravenous chemotherapy for advanced gastric cancer.Methods：A total of 135 advanced gastric cancer patients were postoperatively randomized into two groups;67 patients in treatment group who received IHCP combined with intravenous chemotherapy for four times and 68 patients in control group who received intravenous chemotherapy only for twelve times;All patients in the two groups received the same chemo-regimen FOLFOX6 after 4 weeks of operation.Results：① The 1-year survival rate was 95.38%in the treatment group and 93.21%in the control group without significant difference（P0.05）.The 3-year and the 5-year survival rate was 78.63% and 58.47% in the treatment group,but was 67.95%and 41.81%in the control group with significant difference（P0.05）.②Karnofsky scale（KPS） increasing rate was 59.70%in treatment group versus 42.65%in control group respectively（P0.05）;③ The intraperitoneal recurrence rate in chemotherapy group was lower than that in control group（14.92% vs.30.88%,P0.05）,and the distant metastasis rate without significant difference（32.84%vs.35.29%,P0.05）;④ Most of side effects and complication are gastrointestinal reaction and bone marrow suppression,but no one effect the normal cure.Conclusions：Intraperitoneal hyperthermia chemoperfusion（IHCP）combined with intravenous chemotherapy can prolong survival and reduce gastrointestinal side-effect which provides an effective treatment option for advanced gastric cancer patients.

关 键 词：进展期胃癌 腹腔持续温热灌注化疗 静脉化疗 

分 类 号：R735.2[医药卫生—肿瘤]