紫杉醇腹腔热灌注化疗对胃癌腹膜转移患者生存期的影响  

Effect of HIPEC with paclitaxel on survival of patients with peritoneal metastasis of gastric cancer

作　　者：姚海波[1] 胡俊峰[1] 邵钦树[1] YAO Haibo;HU Junfeng;SHAO Qinshu(Department of Gastroenterology and Pancreatic Surgery,Zhejiang Provincial People's Hospital,People's Hospital of Hangzhou Medial College,Key Laboratory of Gastroenterology of Zhejiang Province,Hangzhou 310014,China)

机构地区：[1]浙江省人民医院胃肠胰外科杭州医学院附属人民医院浙江省胃肠病学重点实验室,浙江杭州310014

出　　处：《全科医学临床与教育》2021年第9期797-799,共3页Clinical Education of General Practice

基　　金：浙江省自然科学基金(LQ19H160013);浙江省医药卫生科技项目(2019323421)。

摘　　要：目的探讨紫杉醇腹腔热灌注化疗(HIPEC)对胃癌腹膜转移患者生存期的影响。方法回顾性分析55例胃癌腹膜转移患者,所有患者均行腹腔镜探查术,术中冰冻病理明确诊断腹膜转移。采用BRTRG-I型高精度体腔热灌注治疗系统,在术后第1天、第3天、第5天使用紫杉醇HIPEC治疗。分析胃癌腹膜转移患者行紫杉醇HIPEC后对生存期的影响,对可能影响生存期的因素进行生存分析。结果胃癌腹膜转移患者使用紫杉醇HIPEC后中位生存时间11个月,1年生存率可以达到49.09%,3年生存率为5.45%。单因素分析显示,肿瘤类型对胃癌腹膜转移患者行HIPEC后生存率有明显影响,差异有统计学意义(χ^(2)=12.97,P<0.05),胃腺癌腹腔转移患者3年生存率较高。性别、年龄、分化程度和肿瘤标志物对胃癌腹膜转移患者行HIPEC后生存率无明显影响,差异均无统计学意义(χ^(2)分别=0.08、0.65、1.45、0.04,P均>0.05)。进一步多元线性回归分析显示,肿瘤类型不能独立影响胃癌腹膜转移患者行紫杉醇HIPEC后的生存率(χ^(2)=3.03,P>0.05)。结论胃癌腹膜转移患者行紫杉醇HIPEC可以延长患者的生存期。胃腺癌腹腔转移患者行紫杉醇HIPEC的预后可能更好。Objective To investigate the effect of hyperthermic intraperitoneal chemotherapy(HIPEC)with paclitaxel on the survival of patients with peritoneal metastasis of gastric cancer.Medthods A retrospective analysis was performed on 55 patients with peritoneal metastasis of gastric cancer.All patients underwent laparoscopic exploration,and peritoneal metastasis was confirmed by intraoperative cryopathology.Paclitaxel HIPEC treatment was performed on the 1st,3rd and 5th day after operation with BRTRG-I high-precision intracavity thermal perfusion system.To analyze the effect of paclitax-el HIPEC on the survival of patients with peritoneal metastasis of gastric cancer,and to analyze the factors that may affect the survival time.Results The median survival time of patients with peritoneal metastasis of gastric cancer after paclitaxel HIPEC was 11 months,the 1-year survival rate was 49.09%,and the 3-year survival rate was 5.45%.Unifactor analysis showed that tumor type had significant influence on the survival rate of patients with gastric cancer with peritoneal metastasis after HIPEC(χ^(2)=12.97,P<0.05),the survival rate of patients with gastric adonocarcinoma was higher.Gender,age,degree of differentiation and tumor markers had no significant effect on the survival time of patients with gastric cancer peritoneal metastasis after HIPEC,and the differences were not statistically significant(χ^(2)=0.08,0.65,1.45,0.04,P>0.05).Further multiple linear regression analysis showed that tumor type did not independently affect the survival rate of gastric cancer patients with peritoneal metastasis af-ter HIPEC(χ^(2)=3.03,P>0.05).Conclusion HIPEC with paclitaxel can prolong the survival of patients with peritoneal metastasis of gastric cancer.For pa-tients with gastric adenocarcinoma,the prognosis may be better.

关 键 词：胃癌 腹膜转移 腹腔热灌注化疗 

分 类 号：R735.2[医药卫生—肿瘤]