内镜下晚期胃癌缩瘤术联合深部热疗对患者长期生存状况的改善  

Locally endoscopic cytoreductive surgery combined with inner diathermy improves survival in patients with advanced gastric cancer

作　　者：胡健[1] 李明峰[1] 赵建华[1] 顾剑锋[1] 曾玥[1] 丁威[1] 李婷婷[1] 

机构地区：[1]中国人民解放军455医院消化肿瘤科,上海市200052

出　　处：《世界华人消化杂志》2014年第16期2294-2299,共6页World Chinese Journal of Digestology

摘　　要：目的:本研究初步评价内镜下局部缩瘤术联合深部热疗治疗晚期胃癌的疗效和安全性.方法:102例无手术治疗指证的晚期胃癌患者,按照所接受的治疗手段进行回顾性分析,分为内镜下缩瘤术联合深部热疗(A组)、内镜下缩瘤术(B组)和最佳支持治疗(C组)3组,收集3个治疗组患者的临床参数、疗效及生存情况并进行对比分析.结果:102例患者中,A组为34例,B组为35例,C组为33例.3组的有效率分别为62%、60%及0,内镜下肿瘤缩小面积比例分别为67.6%、57.5%和-36.1%,中位生存时间分别为15.6、12.9和4.8 mo(P<0.05).和内镜下缩瘤术相关的不良反应主要为出血和便秘,程度轻微,给予对症处理后基本都能缓解.结论:内镜下缩瘤术在晚期胃癌患者中是一种安全有效的局部治疗方法,不良反应轻微,且能和其他的治疗手段有效联合.AIM： To evaluate the efficacy and safety of locally endoscopic cytoreductive surgery combined with inner diathermy in the treatment of advanced gastric cancer. METHODS： Clinical data for 102 patients with inoperable advanced gastric cancer were retrospectively analyzed. The patients were classified into three groups by their treatments： endoscopic cytoreductive surgery combined with inner diathermy（group A）, endoscopic cytoreductive surgery alone（group B） and best supportive care（group C）. Clinical parameters, efficacy and long term survival were compared between the three groups. RESULTS： Of 102 patients, 34 were in group A, 35 in group B, and 33 in group C. Response rates in the three groups were 62%, 60% and 0, respectively. Rates of shrinkage square by endoscopic view were 67.6%, 57.5% and-36.1%, respectively. Median overall survival were 15.6, 12.9 and 4.8 mo（P ＆lt; 0.05）. The most common adverse effects related to endoscopic treatment were bleeding and constipation, which were mild to moderate in severity and easily manageable. CONCLUSION： Endoscopic cytoreductive surgery is effective and safe in patients with advanced gastric cancer. This procedure is well tolerated and can be efficiently combined with other methods.

关 键 词：胃癌 内镜下治疗 深部热疗 

分 类 号：R735.2[医药卫生—肿瘤]