内生场热化疗对胃癌转移性腹腔淋巴结的疗效及血清肿瘤标志物的影响  

The effects of endogenic field hyperthermia combined with intraperitoneal chemotherapy on the treatment outcomes and serum tumor markers of patients with advanced gastric cancer and celiac lymph node metastasis

作　　者：沈清[1] 金赟洁[1] 朱纪华[1] 姚晓祥[1] 朱麟玉[1] 武建毅[1] 黄晓东[1] 

机构地区：[1]上海市普陀区人民医院肿瘤科,上海200060

出　　处：《肿瘤》2011年第9期859-862,共4页Tumor

摘　　要：目的:观察内生场热化疗对胃癌转移性腹腔淋巴结的疗效以及对血清肿瘤特异性生长因子(tumor supplied group of factors,TSGF)、癌胚抗原(carcinoembryonic antigen,CEA)和CA50的影响。方法:2006年10月-2009年12月共收集60例腹腔淋巴结转移的ⅢB～Ⅳ期胃癌患者,随机分为单纯腹腔化疗组(30例,腹腔内注射表柔比星)和腹腔热化疗组(30例,腹腔化疗联合腹腔内生场热疗)。观察近期疗效、不良反应和生存率。监测治疗前后血清TSGF、CEA和CA50的变化。结果:治疗8周后,单纯腹腔化疗组总有效率为63.3%(19/30),腹腔热化疗组的总有效率为90.0%(27/30),两组差异有统计学意义(P<0.01)。腹腔热化疗组的1年生存率为73.3%(22/30),高于单纯腹腔化疗组的50.0%(15/30)。治疗后,腹腔热化疗组的血清TSGF、CEA和CA50的下降幅度要大于单纯腹腔化疗组(P<0.01)。两组的不良反应发生率相似。结论:内生场热化疗对于腹腔淋巴结转移的晚期胃癌患者而言,是一种有效的治疗方式。血清TSGF联合CEA和CA50等肿瘤标志物可作为内生场热化疗的疗效监测指标。Objective：To observe the effects of endogenic field hyperthermia combined with intraperitoneal chemotherapy on the treatment outcomes and serum tumor markers [tumor supplied group of factors（TSGF）,carcinoembryonic antigen（CEA） and CA50] of patients with advanced gastric cancer and celiac lymph node metastasis.Methods：Sixty patients with stage ⅢB-Ⅳ gastric cancer and celiac lymph node metastasis were recruited between October 2006 and December 2009,and then they were randomly divided into two groups,including intraperitoneal chemotherapy group [n=30,treated with intraperitoneal chemotherapy（adriamycin） ] and hyperthermic intraperitoneal chemotherapy group（n=30,treated with endogenic field hyperthermia combined with intraperitoneal chemotherapy）.The short-term response,overall survival,adverse reactions,and the changes of serum TSGF,CEA and CA50 levels before and after treatment were evaluated.Results：After 8 weeks of treatment,the total response rates of the intraperitoneal chemotherapy group and the hyperthermic intraperitoneal chemotherapy group were 63.3%（19/30） and 90.0%（27/30）,respectively,and the difference between the two groups was significant（P〈0.01）.The one-year survival rate in the hyperthermic intraperitoneal chemotherapy group was higher than that in the intraperitoneal chemotherapy group [73.3%（22/30） vs 50.0%（15/30）,P〈0.01].After treatment,there was a more significant decrease in serum TSGF,CEA and CA50 levels in the hyperthermic intraperitoneal chemotherapy group as compared with that in the intraperitoneal chemotherapy group（P〈0.01）.The rates of adverse reactions in these two groups were similar.Conclusion：Endogenic field hyperthermia combined with intraperitoneal chemotherapy is an effective treatment for patients with gastric cancer and celiac lymph node metastasis.Serum TSGF,CEA and CA50 may be considered as some of the measurements to monitor the efficacy of hyperthermic chemotherapy.

关 键 词：胃肿瘤 肿瘤转移 高温 诱发 肿瘤特异性生长因子 癌胚抗原 

分 类 号：R735.2[医药卫生—肿瘤]