进展期胃癌围术期三联序贯区域化疗的效果  

Effect of triple sequential chemotherapy during the perioperative period of advanced gastric cancer

作　　者：刘桂[1] 李万浪 巫佳明 

机构地区：[1]广西科技大学第二附属医院胃肠外科,广西柳州545006

出　　处：《海南医学》2014年第15期2205-2208,共4页Hainan Medical Journal

摘　　要：目的：探讨进展期胃癌围术期三联序贯区域化疗的临床效果。方法回顾性分析2005-2007年85例进展期（Ⅱ、Ⅲ期）胃癌患者的临床资料，根据患者意愿非随机分成治疗组和对照组。治疗组44例术前经数字减影血管造影（DSA）选择性动脉插管化疗1～2次，1周后行胃癌根治术（D2），术中施行腹腔温热灌注化疗并安置化疗泵，术后1～2周经化疗泵行灌注化疗。对照组41例行胃癌根治术（D2）＋术后全身静脉化疗。比较两组的根治性切除率，术后并发症，局部复发率，远处转移率，1、3及5年生存率。结果两组间术后并发症差异无统计学意义（P〉0.05）。治疗组根治性切除率、局部复发、肝转移和腹腔转移率（88.6%、18.2%、15.9%和22.7%）与对照组（58.5%、39.0%、36.6%和43.9%）分别比较差异均有统计学意义（P〈0.05）；治疗组3、5年生存率为81.8%、56.8%，高于对照组的51.2%、34.1%，差异均具有统计学意义（P〈0.05）。结论胃癌围术期三联序贯化疗安全可行，可显著减少局部复发率和远处转移率，提高生存率。Objective To investigate the clinical effect of triple sequential chemotherapy during the perioperative period of advanced gastric cancer. Methods Eighty-five advanced gastric patients （StageⅡand stageⅢ） who underwent the operation between 2005 and 2007 in our hospital were included in this retrospective study. They were divided into treatment group （44 cases） and control group （41 cases） according to the wish of patients. Patients in the treatment group underwent one or two times of selective arterial chemotherapy by DSA one week before D2 lymphad-enectomy. Moreover, they were executed the intraperitoneal hyperthermic perfusion chemotherapy and installed che-motherapy pump during the operation. Then infusion chemotherapy by chemotherapy pump were carry out one or two weeks after surgery. Instead, patients in the control group underwent the D2 lymphadenectomy and postoperative systemic venous chemotherapy. Curative resection rate, postoperative complications, local recurrence rate, distant metastasis rate and 1, 3 and 5 year survival rate in each group were compared. Results There were no significant difference between two groups at postoperative complications （P〉0.05）. There were significant differences （P〈0.05） between two groups at curative resection rate （88.6%vs 58.5%） , local recurrence rate （18.2%vs 39.0%）, liver metastasis rate （15.9%vs 36.6%） , peritoneal metastasis rate （22.7%vs 43.9%） , 3 year survival rate （81.8%vs 51.2%） and 5 year survival rate （56.8%vs 34.1%）. Conclusion Triple sequential chemotherapy was safe and feasible which would significantly reduce local recurrence rate and distant metastasis rate and improve survival rate during the perioperative period of advanced gastric cancer.

关 键 词：胃癌 三联序贯区域化疗 围术期 

分 类 号：R735.2[医药卫生—肿瘤]