72例胃癌肝转移化疗后进展的介入治疗的回顾性分析  

Interventional treatment for progressive hepatic metastases from gastric cancer after chemotherapy:a retrospective analysis of 72 cases

作　　者：刘鹏[1] 朱旭[1] 杨仁杰[1] 陈辉[1] 徐海峰[1] 高嵩[1] 朱林忠[1] 王晓东[1] 

机构地区：[1]北京大学肿瘤医院暨北京市肿瘤防治研究所介入治疗科,教育部恶性肿瘤发病机制及转化研究重点实验室

出　　处：《介入放射学杂志》2013年第9期742-746,共5页Journal of Interventional Radiology

基　　金：中华国际医学交流基金会"肿瘤介入治疗临床规范化研究"项目(医基发2008-17);国家传染病防治科技重大专项(2008ZX10002-26)

摘　　要：目的对肝动脉灌注化疗为主的介入治疗在胃癌肝转移治疗中的效果及安全性进行回顾性分析。探讨作为化疗后进展的二线治疗手段，介入治疗的实施注意事项及与预后相关因素。方法系统回顾2006年6月至2011年8月胃癌肝转移化疗后进展而进行介入治疗的患者72例，收集介入治疗的方法、动脉灌注的化疗方案等具体资料，对定量资料进行方差分析，定性资料则采用x^2检验，用Kaplan—Meier法估计生存率，用Log—rank检验进行生存率的比较，并纳入COX回归模型进行多因素分析。结果人组的胃癌肝转移患者介入治疗后中位无进展生存期5．0个月、中位生存期8．0个月，有效率40．3％（29／72），疾病控制率77．8％（56／72），与治疗效果相关的因素有肿瘤血供及染色情况、是否使用含OXA的化疗方案。在使用相同方案情况下，静脉化疗进展后的患者经介入治疗仍取得CR1例（3．8％，1／26）．PR12例（46．2％，12，26），SD9例（34．6％，9／26）的效果，无明显不良反应发生。结论介入治疗胃癌肝转移的方法安全有效，但仍需进一步探究规范介入治疗的方法，以完善介入治疗在转移性肝癌中的应用。Objective To evaluate the efficacy and safety of hepatic arterial infusion chemotherapy in treating progressive liver metastases from gastric cancer, and to retrospectively analyze the relationship between the interventional treatment and the prognosis. Methods During the period from June 2006 to August 201 1, a total of 72 patients with progressive hepatic metastases from gastric cancer after systemic chemotherapy were admitted to authors＇ hospital. The clinical data, including the interventional managements, the arterial chenmperfusion scheme, etc., were retrospectively analyzed. For the quantitative data variance analysis was used, while for the qualitative data chi- squared test was adopted. Kaplan-Meier method was employed to estimate the survival rate, and Log-rank test was used to compare the survival rates, which was brought into Cox regression model for multi- factor analysis. Results After interventional treatment, the median progress- free survival time was 5.0 months and the median survival time was 8.0 months with an overall respond rate of 40.3% （29/72） and a disease-control rate of 77.8% （56/72）. The factors related to the therapeutic results included the blood supply of tumor, tumor staining, use of OXA chemotherapy scheme, etc. When the same therapeutic scheme was employed, the interventional management for the patients with progressive hepatic metastases from gastric cancer after systemic chemotherapy still could get satisfactory results： CR in one case （3.8%, 1/26）, PR in 12 cases （46.2%, 12/26） and SD in 9 cases （34.6%, 9/26） with no obvious adverse effects. Conclusion For the treatment of liver metastases from gastric cancer, interventional management is safe and effective, although standard intervention scheme is needed to be further studied in order to perfect its clinical application. （J Intervent Radio/, 2013, 22： 742- 746）

关 键 词：胃癌肝转移 肝动脉灌注化疗 回顾性研究 无进展生存期 总生存期 

分 类 号：R735.2[医药卫生—肿瘤]