动脉置泵靶向化疗在晚期胃癌中的应用  

Targeting chemotherapy via arterial infusion for advanced gastric cancer

作　　者：曹志宇[1] 蒲永东[1] 杨波[1] 吴友军[1] 张博[1] 史玉琪[1] 

机构地区：[1]解放军309医院普通外科,北京100091

出　　处：《解放军医学杂志》2011年第10期1103-1104,共2页Medical Journal of Chinese People's Liberation Army

摘　　要：目的探讨动脉内置泵靶向化疗对晚期胃癌的疗效。方法对47例无法切除的晚期胃癌采用动脉置泵灌注化疗,化疗方案:氟尿嘧啶(5-FU)500mg/m2,吡柔比星(MMC)10mg/m2,羟喜树碱(HPT)20mg/m2,每周2次,2周为1个疗程,休息3周后重复,共2～3个疗程。结果完全缓解(CR)1例,部分缓解(PR)28例,稳定(SD)16例,进展(PD)2例。有效率(PR+CR)为61.7%,28例PR患者中手术切除4例,占8.5%。术后病理检查发现癌细胞均有不同程度的核固缩、碎裂、胞质凝固、变性,细胞间质水肿、纤维增生、炎细胞浸润,血管内膜增厚、血栓形成。患者1、2、3年生存率分别为70.2%(33/47)、14.9(7/47)、2.1%(1/47),平均生存期为17.2个月。结论动脉置泵靶向化疗作为晚期胃癌综合治疗的一部分,可以改善患者生活质量,提高手术切除率。Objective To evaluate the clinical effects of chemotherapy via arterial infusion in treatment of advanced gastric cancer.Methods Forty-seven patients with advanced gastric cancer were given chemotherapy via arterial infusion.Chemotherapy plan was as follows： 5-Fluorouracil（Fu） 500mg/m2,cyclophosphamide（MMX） 10mg/m2,Hydroxycamptothecin（HPT） 20mg/m2,once per week,2 weeks as a course,a total of 2-3 courses.Results After chemotherapy via arterial infusion,complete remission（CR） was achieved in 1 case,partial remission（PR） in 28 cases,stabilization of disease（SD） in 16 cases,progression of disease（PD） was found in 2 cases,and rate with response（CR＋PR） was 61.7%.Four of 28 PR patients underwent tumorectomy,the pathology revealed the presence of cancer cells around the vascular vessels,manifesting karyopyknosis,karyorrhexis,coagulation and necrosis of cytoplasm,intercellular edema,hyperplasia of fibroblasts,inflammatory cell infiltration,thickening of endothelium,and thrombosis.One,two and three-year survival rates were 70.2%,14.9% and 2.1%,respectively.The average survival period was 17.2 months.Conclusion Targeting chemotherapy via arterial infusion,as a part of the combined treatment,is beneficial to the patients with unresectable advanced gastric cancer.

关 键 词：胃肿瘤 导管 留置 药物疗法 

分 类 号：R735.2[医药卫生—肿瘤]