术中及术后早期腹腔热灌注化疗联合全身静脉化疗治疗进展期胃癌  

Intraperitoneal thermo-lavage chemotherapy combined with general venous chemotherapy in operation and early stage post operation for advanced gastric cancer

作　　者：韩光宏[1] 蒋林哲[1] 王爱光[1] 

机构地区：[1]吉林省吉林市第二中心医院普通外科,132001

出　　处：《中国临床研究》2011年第7期559-561,共3页Chinese Journal of Clinical Research

基　　金：吉林省吉林市科技计划项目(201032267)

摘　　要：目的探讨对进展期胃癌采用术中及术后早期腹腔热灌注化疗联合全身静脉化疗治疗的疗效。方法将2001年12月至2005年12月收治的164例进展期胃癌患者行根治性或姑息性切除术后分为2组,2组基线资料均衡。治疗组84例采用术中及术后早期腹腔热灌注化疗联合全身静脉化疗;对照组80例采用单纯全身静脉化疗。中位随访时间46个月,比较2组疗效。结果 2组比较,患者术后生存率在第1、2年差异无统计学意义(P均>0.05),在第3、4、5年治疗组明显高于对照组(61.9%vs45.0%,P<0.05;52.4%vs32.5%,P<0.05;42.9%vs21.3%,P<0.01)。2组术后原发部位肿瘤复发率相近(27.4%vs23.8%,P>0.05),但腹腔种植转移率(21.4%vs42.5%,P<0.01)、远处转移率(57.1%vs78.8%,P<0.01)、总复发及转移率(63.1%vs83.8%,P<0.01)治疗组明显低于对照组。2组白细胞、血小板减少,肝肾功能异常及恶心、腹泻、脱发等副反应发生率比较,差异无统计学意义(P均>0.05),腹痛、腹胀发生率治疗组高于对照组(P<0.05),但对症处理后即可缓解。结论术中及术后早期腹腔热灌注化疗联合全身静脉化疗方案能改善局部治疗效果,远期疗效优于单纯化疗,复发率及转移率低,且毒副反应可耐受。Objective To explore the efficacy of intraperitoneal thermo-lavage chemotherapy combined with general venous chemotherapy in operation and early stage post operation for advanced gastric cancer.Methods A total of 164 patients with advanced gastric cancer underwent radical or palliative excision between December 2001 and December 2005 were randomly divided into two groups： treatment group （n=84） and control group （n=80）.The basic data were comparable in two groups.Intraperitoneal thermo-lavage chemotherapy combined with general venous chemotherapy in operation and early stage post operation was used in treatment group,and general venous chemotherapy alone was used in control group.The therapeutic effect in two groups was compared.The median follow-up time was 46 months.Results There was no significant difference in 1- and 2-year survival rates post operation （all P0.05）,but the 3-,4- and 5-year survival rates were higher in treatment group than those in control group （61.9% vs 45.0%,P0.05;52.4% vs 32.5%,P0.05;42.9% vs 21.3%,P0.01）.The tumor recurrence rates at primary site post operation were similar in two groups （27.4% vs 23.8%,P0.05）,but the metastasis rates of intra-abdominal implantation （21.4% vs 42.5%,P0.01） and distal position （57.1% vs 78.8%,P0.01）,total recurrence and metastasis rates （63.1% vs 83.8%,P0.01） in treatment group were lower than those in control group.The occurrence rates of leukopenia,thrombocytopenia,liver and renal dysfunction,nausea,diarrhea,alopecia had no significant difference （all P0.05）,while occurrence rates of abdominal pain and abdominal distension in treatment group were all higher than those in control group,but these symptoms could be relieved after expectant treatment.Conclusions The scheme of intraperitoneal thermo-lavage chemotherapy combined with general venous chemotherapy in operation and early stage post operation could improve local therapeutic effect,and the long-term therapeutic effect is superior to single general venous chemoth

关 键 词：胃肿瘤 腹腔热灌注 化学药物疗法 

分 类 号：R735.2[医药卫生—肿瘤] R730.5[医药卫生—临床医学]