动脉灌注化疗加栓塞微球栓塞治疗中晚期贲门癌的近期疗效观察  

Short term curative effect of intra-arterial infusion chemotherapy combined with trisacryl gelatin microspheres embolization in treating cardia cancer

作　　者：胡鸿涛[1] 黎海亮[1] 郭晨阳[1] 孟艳莉[1] 姚全军[1] 肖金成[1] 程洪涛[1] 郑琳[1] 陈呈世[1] 

机构地区：[1]河南省肿瘤医院郑州大学附属肿瘤医院放射介入科,450008

出　　处：《中华放射学杂志》2013年第12期1115-1119,共5页Chinese Journal of Radiology

摘　　要：目的 探讨动脉内灌注化疗术加栓塞微球栓塞术治疗贲门癌的近期临床疗效.方法 前瞻性将39例经病理证实为中晚期贲门癌患者随机分为A、B2组,A组为灌注＋栓塞组,共19例,对贲门肿瘤采用介入术中动脉灌注化疗加栓塞微球栓塞的治疗方法;B组为单纯灌注组,共20例,单纯对贲门肿瘤行动脉灌注化疗术.所用化疗方案均为奥沙利铂＋脱氧氟尿苷.对2组中伴有肝转移的患者同时行肝转移癌动脉化疗栓塞.对所有患者进行随访,主要随访指标为患者上腹部CT检查结果、消化道造影、血常规、肝肾功能、电解质及大便潜血.计数资料采用x2检验,P＜0.05为差异有统计学意义.采用Kaplan-Meier法计算生存时间,Log-rank检验（Wilcoxon-Breslow）比较2组患者的生存曲线.结果 患者随访时间为3～27个月,A组患者中位生存期为17.5个月,6、12和18个月生存率分别为89.5％ （17/19）、84.2％（16/19）和26.3％ （5/19）;B组患者中位生存期为12.5个月,6、12和18个月生存率分别为65.0％（13/20）、30.0％（6/20）和0（0/20）.2组间生存期的差异有统计学意义（Log-rank检验x2=26.755,P ＜0.01）.治疗后2组吞咽困难程度的改善差异有统计学意义（t=2.885,P＜0.01）.结论 动脉灌注化疗加栓塞微球栓塞术治疗贲门癌可较单纯灌注化疗术更快地缩小肿瘤、快速缓解吞咽困难等症状,提高患者近期生存率,改善生活质量,是一种有效的治疗方法.Objective To evaluate the short term curative effect of cardia cancer treated by intraarterial infusion chemotherapy combined with trisacry gelatin microspheres enbolization.Methods A prospective study was performed,39 patients with cardlia cancer pathologically confirmed were included into this study and then they were randomly assigned into two groups of group A and group B.Group A included 19 patients and the patients were treated by intra-arterial infusion chemotherapy combined with trisacryl gelatin microspheres embolization.Group B included 20 patients and treated by intra-arterial infusion chemotherapy only.Protocols of chemotherapy were Oxaliplatin （100-150 mg） combined with Doxifluridine （2000-2500 mg）.During the interventional procedure,if the patients had hepatic metastasis,the hepatic metastasis were treated by intra-arterial chemoembolization.All of the patients underwent follow up by telephone or patients hospitalization.Statistical analysis was performed by x2 test,Kaplan-Meier and Log-rank test.Results All the patients were followed up 3-27 months.The median survival was 17.5 months,the 6-month,12-month and 18-month overall survival rates were 89.5% （17/19）,84.2% （16/19） and 26.3% （5/19）in group A,respectively.The median survival was 12.5 months,the 6-month,12-month and 18-month overall survival rates were 65.0% （13/20）,30.0% （6/20）and 0（0/20）in group B,respectively.The median survival had statistically significant difference between group A and group B （Log-rank test,x2 =26.755,P 〈 0.01）.There were statistically significant difference of dysphagia improvement in group A and B after therapy（t =2.885,P 〈 0.01）.Conclusions Intra-arterial infusion chemotherapy combined with trisacryl gelatin microspheres enbolization can minificate the tumor promptly and improve disphagia in patients with cardia cancer,and also is an effective method which can prolong patent＇s survival period and improve quality of life.

关 键 词：胃肿瘤 化学栓塞 治疗性 放射学 介入性 

分 类 号：R735.2[医药卫生—肿瘤]