洛铂联合多西他赛行肿瘤细胞减灭术加腹腔热灌注化疗治疗同时性胃癌腹膜癌  

Treatment of synchronous peritoneal carcinomatosis from gastric cancer with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy with lobaplatin and docetaxel

作　　者：武海涛[1] 姬忠贺[1] 张倩[1] 彭开文[1] 李雁[1,2] 

机构地区：[1]武汉大学中南医院肿瘤科,肿瘤生物学行为湖北重点实验室,湖北省肿瘤医学临床研究中心,武汉市430071 [2]首都医科大学附属北京世纪坛医院肿瘤中心腹膜肿瘤外科

出　　处：《中国肿瘤临床》2016年第4期146-151,共6页Chinese Journal of Clinical Oncology

基　　金：2013年湖北省医学领军人才培养工程项目(编号:鄂卫生计生发[2013]4号);教育部博士点基金(编号:20120141110042)资助~~

摘　　要：目的：分析洛铂联合多西他赛行肿瘤细胞减灭术（cytoreductive surgery,CRS）加腹腔热灌注化疗（hyperthermic intraperitoneal chemotherapy,HIPEC）治疗同时性胃癌腹膜癌（peritoneal carcinoma,PC）的疗效及安全性。方法：50例胃癌PC患者接受52次CRS＋HIPEC治疗,药物为洛铂100 mg、多西他赛120 mg,加入12 000 mL生理盐水加热至（43±0.5）℃持续灌注60 min。主要终点指标为总生存期,次要终点评价指标为围手术期安全性。结果：患者中位随访期22.5个月,中位生存期14.3个月（95%CI：7.6-21.0）,1、2、3年生存率分别为58%、40%、32%。无围手术期死亡,12例（23.1%）出现严重不良事件。多因素分析显示,完全细胞减灭、术前肿瘤标记物水平正常、术后化疗≥6个周期为影响预后的独立因素。结论：对于同时性胃癌PC患者,洛铂联合多西他赛行CRS＋HIPEC可延长患者的总生存期,安全可行。Objective： To evaluate the efficacy and safety of combined cytoreductive surgery（CRS） and hyperthermic intraperitoneal chemotherapy（HIPEC） with lobaplatin and docetaxel for treatment of synchronous peritoneal carcinomatosis（PC） from gastric cancer.Methods： Fifty patients with synchronous PC from gastric cancer were treated by 52 CRS＋HIPEC procedures with 100 mg of lobaplatin and 120 mg of docetaxel in 12000 mL of normal saline at（43 ± 0.5）℃ for 60 min. The primary and secondary endpoints were overall survival（OS） and perioperative safety profiles, respectively. Results： At a median follow- up of 22.5 months, the median OS rate was14.3（95% CI： 7.6- 21.0） months, and the 1-, 2-, and 3- year survival rates were 58%, 40%, and 32%, respectively. No perioperative deaths or serious adverse events occurred in 12 cases（23.1%）. Multivariate analysis indicated that completeness of cytoreduction, normality of perioperative tumor markers, and adjuvant chemotherapy of more than six cycles were independent predictors for improved survival. Conclusions： CRS＋HIPEC with lobaplatin and docetaxel could improve the OS and ensure perioperative safety of patients with synchronous PC from gastric cancer.

关 键 词：洛铂 多西他赛 胃癌 腹膜癌 细胞减灭术 腹腔热灌注化疗术 

分 类 号：R735[医药卫生—肿瘤]