进展期胃癌术中腹腔内温热化疗联合缓释氟尿嘧啶植入的临床应用  

Clinical application of intraoperative intraperitoneal hyperthermic chemotherapy using sustained-re-lease fluorouracil in radical gastrectomy for gastric cancer

作　　者：万能斌[1] 张理[1] 左朝晖[1] 何潇[1] 林劲冠[1] 潘曙光[1] 尹彬[1] 罗威[1] 朱海珍[2] 欧阳永忠[1] 

机构地区：[1]湖南省肿瘤医院胃胰腺胆道外科,长沙410013 [2]湖南大学生物学院癌症研究中心

出　　处：《中国医师杂志》2012年第6期763-766,共4页Journal of Chinese Physician

摘　　要：目的探讨进展期胃癌根治术中腹腔内温热化疗联合缓释氟尿嘧啶植入的临床安全性。方法回顾性分析本院2002年9月至2011年9月收治的280例进展期胃癌的临床资料，按治疗方法分三组研究。对三组并发症、死亡率和累积生存率进行比较。结果三组并发症比较差异无统计学意义（P〉0．05），腹腔内温热化疗联合缓释氟脲嘧啶植入组术后5年复发率（16．18％）低于腹腔内温热化疗组（37．61％）和单纯手术组（41：28％），差异均有统计学意义（P〈0．05）。腹腔内温热化疗联合缓释氟尿嘧啶植入组1，3和5年累积生存率分别为85．51％、61．28％和53．67％，腹腔内温热化疗组1，3和5年累积生存率分别为84．11％、39．98％和28．12％，单纯手术组1，3和5年累积生存率分别为81．28％、29．88％和25．21％。三组1年累积生存率比较差异无统计学意义（P〉0．05），而腹腔内化疗联合缓释氟尿嘧啶植入组3和5年累积生存率显著高于腹腔内温热化疗组和单纯手术组（P〈0．05）。结论进展期胃癌根治术中腹腔内温热化疗联合缓释氟尿嘧啶植入的临床治疗是一种简单、安全和有效的综合治疗方法，具有杀灭腹腔游离的癌细胞，可降低术后的复发率和提高生存率。Objective To investigate clinical application of intraoperative intraperitoneal hyperther- mic chemotherapy using sustained-release fluorouracil in radical gastrectomy for advanced gastric cancer. Methods The clinical data of 280 advanced gastric cancer patients admitted from September, 2002 to Sep- tember, 2010 were analyzed retrospectively. They were divided into three groups randomly and followed up. The postoperative morbidity, the mortality and the overall survival rates were evaluated. Results There were no significant differences in these three groups with respect to postoperative morbidity （ P 〉 0. 05）. The incidence of recurrence in intraperitoneal chemotherapy using sustained-release fluorouracil （treatment group） was significantly lower than those of intraperitoneal chemotherapy and operative treatment（ 16. 18%, 37. 61% and 41.28%, P 〈 0. 05）. The 1,3- and 5-year overall survival rates of treatment group were 85.51% ,61.28% and 53.67%, respectively, and the 1-,3- and 5-year overall survival rates were 84. 11% ,39. 98% and 28. 12%, and 81.28% ,29. 88% and 25.21% respectively in intrapeitoneal chemo- therapy group and operative group. 1-year overall survival rate had no significant differences among three groups with respect to （ P 〉 O. 05）. 3-and 5-year overall survival rates in treatment group were higher sign-ificanfly than those of intraperitaneal chemotherapy and operative treatment （ P 〈 0. 05）. Conclusions In- traoperative intrapeitoneal hyperthermic chemotherapy using sustained-release fluorouracil is a kind of con- venient, safe, and highly effective comprehensive treatment method, and it can kill isolated intraperitoneal cancer cells. It may reduce postoperative recurrence and improve survival rates.

关 键 词：胃肿瘤/外科学/药物疗法 抗肿瘤联合化疗方案/治疗应用 高温 诱发 注射 腹 腔内 氟尿嘧啶/投药和剂量 ' 

分 类 号：R735.2[医药卫生—肿瘤]