区域动脉化疗栓塞联合全身静脉化疗对局部进展期胃癌的疗效  

Neoadjuvant therapy of regional intra-arterial combined systemic vein chemotherapy for locally advanced gastric cancer

作　　者：宋展[1] 钱国武[1] 吕柯[1] 张海洋[1] 王新伟[1] 孙晓林[1] 

机构地区：[1]郑州大学附属南阳医院(南阳市中心医院)普通外科,473009

出　　处：《中华普通外科杂志》2017年第1期30-33,共4页Chinese Journal of General Surgery

摘　　要：目的评估局部进展期胃癌应用区域动脉化疗栓塞联合全身静脉化疗的安全性和有效性。方法回顾性分析郑州大学附属南阳医院自2010年1月至2012年12月收治的接受新辅助治疗后行根治性手术切除的局部进展期胃癌患者的临床资料，其中术前行区域动脉化疗栓塞联合全身静脉化疗36例（研究组），术前单独行全身静脉化疗42例（对照组），于新辅助治疗后3～4周行手术切除。两组患者均于术后3．4周按mFOLFOX6方案行全身静脉化疗。结果研究组的化疗毒性反应和术后吻合口瘘的发生率均低于对照组（均P〈0．05）：两组的1年复发率和生存率相比差异均无统计学意义（X2=2．431、1．605，均P〉0．05）；研究组的3年肝转移发生率低于对照组（x2=4．063，P〈0．05），3年生存率高于对照组（X2=4．396，P〈0．05）。结论区域动脉化疗栓塞联合全身静脉化疗的新辅助治疗可降低局部进展期胃癌患者的化疗毒性反应、吻合口瘘及术后肝转移的发生率，提高3年生存率。Objective To investigate the efficacy and safety of preoperative regional intra-arterial chemoembolization combined with systemic vein chemotherapy in the treatment of locally advanced gastric cancer. Methods The clinical data of 78 locally advanced gastric cancer patients treated by radical D2 gastretomy from January 2010 to December 2012 were retrospectively analyzed. Patients were devided into treatment group receiving regional intra-arterial chemoembolization combined with systemic vein chemotherapy （ n = 36 ）, and those with preoperative systemic vein chemotherapy （ n = 42 ） 3 to 4 weeks before surgery. Systemic chemotherapy with mFOLFOX6 was started after 5 weeks of surgery in the two groups. Results The incidence of toxicity reaction and postoperative anastomotic leakage were lower in treatment group than in control group, all P 〈 0.05. The 1-year recurrence and overall survival rate were similar between the two groups （ all P 〉 0. 05 ）. The 3-year liver metastasis rate was higher in treatment group than in control group （x2 = 4. 063, P 〈 0. 05 ）. The 3-year survival rate was higher than that of the control group（x2 = 4. 396, P 〈 0. 05 ）. Conclusions Preoperative systemic vein chemotherapy combined with regional intra-arterial chemoembolization decreases toxicity reaction, anastomotic leakage and liver metastasis, while prolonging 3-year overall survival.

关 键 词：胃肿瘤 化学疗法 肿瘤 局部灌注 放化疗 辅助 

分 类 号：R735.2[医药卫生—肿瘤]