局部进展期胃癌术前全身静脉联合区域动脉灌注化疗栓塞的疗效评价  

Preoperative systemic chemotherapy plus regional intraarterial chemoembolization for patients withlocally advanced gastric cancer

作　　者：郜永顺[1] 钱国武[1] 张云飞[1] 吴刚[2] 李文才[3] 赵武干[3] 赵阳阳[3] 

机构地区：[1]郑州大学第一附属医院胃肠外科,450052 [2]郑州大学第一附属医院介入科,450052 [3]郑州大学第一附属医院病理科,450052

出　　处：《中华普通外科杂志》2013年第10期736-739,共4页Chinese Journal of General Surgery

摘　　要：目的 探讨局部进展期胃癌术前全身静脉联合区域动脉灌注化疗栓塞的有效性和安全性.方法 分析郑州大学第一附属医院胃肠外科自2008年1月至2012年7月收治的158例接受新辅助治疗后行手术切除的局部进展期胃癌患者的临床资料,其中术前全身静脉联合区域动脉灌注化疗栓塞者78例（A组）,术前全身静脉化疗者80例（B组）,休息3～4周后手术.比较两组术后组织病理学疗效、化疗毒性反应发生率及术后并发症发生率.结果 两组术后标本的组织病理学评估均有效,A组和B组的疗效满意率分别是60％和42％,差异有统计学意义（X2 =6.136,P＜0.05）；A组化疗毒性反应（除外恶心反应）和术后吻合口瘘、肠梗阻、切口愈合不良、腹腔感染及肺部感染等并发症发生率均低于B组（均P＜0.05）,而恶心反应发生率高于B组（x2=16.458,P＜0.01）；两组均无新辅助治疗相关死亡病例.结论 局部进展期胃癌术前全身静脉联合区域动脉灌注化疗并栓塞的疗效确切,可降低化疗毒性反应,并且不增加术后并发症的发生率.Objective To investigate the efficacy and safety of preoperative systemic chemotherapy combined with regional intraarterial chemoembolization in the treatment of locally advanced gastric cancer.Methods Clinical data of 158 patients of locally advanced gastric receiving neoadjuvant chemotherapy cancer from January 2008 to July 2012 were retrospectively analyzed.Patients were divided into two groups：those who received preoperative systemic chemotherapy plus regional intraarterial chemoembolization （group A,n =78） and those who received preoperative systemic chemotherapy （group B,n =80）.Radical resection was perfomed after 3 to 4 weeks.Results The overall satisfactory rate was significantly higher （60%） in group A compared with 42% in group B （x2 =6.136,P 〈0.05）.The incidence rate of toxicity reaction （except nausea） and postoperative conplications such as anastomotic leakage,intestinal obstruction,poor wound healing,abdominal infection and pulmonary infection were all lower in group A than in group B （all P 〈 0.05）,while the incidence rate of nausea was higher in group A than in Group B （x2 =16.458,P 〈 0.01）.There was no perioperative mortality related to neoadjuvant therapy in two groups.Conclusions Preoperative systemic chemotherapy combined with regional intraarterial chemoembolization was associated with better efficacy,and fewer toxicity reactions and postoperative complications in the treatment of locally advanced gastric cancer.

关 键 词：胃肿瘤 化学疗法 肿瘤 局部灌注 化学疗法 辅助 

分 类 号：R735.2[医药卫生—肿瘤]