经导管胃左动脉持续灌注化疗治疗全身化疗失败的不可切除贲门癌的疗效及安全性  

Efficacy and safety of transcatheter left gastric artery continuous infusion chemotherapy in the treatment of unresectable cardiac cancer with systemic chemotherapy failure

作　　者：刘松 于广计 张永会 王庆东 LIU Song;YU Guangji;ZHANG Yonghui;WANG Qingdong(Department of Intervention,Linyi Cancer Hospital,Linyi,Shandong 276034,China)

机构地区：[1]临沂市肿瘤医院介入科,山东临沂270034

出　　处：《中国肿瘤外科杂志》2022年第6期600-605,共6页Chinese Journal of Surgical Oncology

基　　金：临沂市科技发展计划项目(202020058)。

摘　　要：目的观察经导管胃左动脉持续灌注化疗治疗全身化疗失败的不可切除贲门癌的疗效及安全性。方法回顾性分析临沂市肿瘤医院2019年6月至2021年6月收治的经全身化疗失败的不可切除贲门癌患者24例,均合并不同程度进食梗阻症状,所有患者均接受FOLFOX方案经导管胃左动脉(必要时选择胃右动脉,胃网膜左、右动脉,左膈下动脉和胃后、短动脉等优势动脉)持续灌注化疗,应用Stooler标准评估患者进食梗阻症状变化情况;记录患者的生存时间、不良反应及生活质量变化。结果随访截至2022年3月,24例患者行介入治疗2~6次,平均(3.79±1.16)次,首次治疗后1周,梗阻症状缓解率100%,中位持续缓解时间143 d。治疗2个周期后,患者客观缓解率为45.83%(11/24),疾病控制率为95.83%(23/24);肿瘤标志物(癌胚抗原、糖类抗原19-9、糖类抗原72-4)在术后7、30 d均较术前下降,术后30 d基本降至正常范围。6、12、24个月生存率分别为91.7%、53.2%、8.3%,中位生存时间13.0个月。治疗2个周期后,患者疼痛、恶心呕吐、食欲减退症状均有改善,生活质量明显提高。术后不良反应主要为腹痛、恶心、呕吐及骨髓抑制,均≤2级,均经对症治疗后好转。结论经导管胃左动脉持续灌注化疗治疗全身化疗失败的不可切除贲门癌的近期疗效显著且安全,可显著改善患者的生活质量,并能在一定程度上延长患者的生存时间。Objective To observe the efficacy and safety of transcatheter left gastric artery continuous infusion chemotherapy in the treatment of unresectable cardiac cancer with systemic chemotherapy failure.Methods From June 2019 to June 2021,24 patients with unresectable cardiac cancer who failed to undergo systemic chemotherapy in our hospital were retrospectively analyzed.All patients were accompanied with different degrees of eating obstruction symptoms.All patients were received continuous perfusion chemotherapy using FOLFOX scheme through the left gastric artery(if necessary,select the right gastric artery,left and right gastroepiploic arteries,left inferior phrenic artery,posterior gastric artery,short artery and other dominant arteries).Stooler criteria were used to evaluate the changes of eating obstruction symptoms,and the survival time,adverse reactions and changes in quality of life were recorded.Results Follow-up by March 2022,24 patients were treated with interventional therapy for 2-6 times,with an average of(3.79±1.16)times.One week after the first treatment,the remission rate of obstructive symptoms were 100%,and the median continuous remission time was 143 days.After 2 cycles of treatment,the ORR was 45.83%(11/24)and DCR was 95.83%(23/24).The tumor markers(CEA,CA19-9,CA72-4)were decreased after 7 and 30 days of operation compared to before operation,and decreased to the normal range after 30 days of operation.The 6,12,24 months survival rates were 91.7%,53.2%,8.3%respectively,and the median survival time was 13.0 months.After 2 cycles of treatment,the patients pain,nausea,vomiting and anorexia were improved,and the quality of life was significantly improved.The main postoperative adverse reactions were abdominal pain,nausea,vomiting and bone marrow suppression,which were≤grade 2,and improved after symptomatic treatment.Conclusions Continuous infusion chemotherapy based on left gastric artery for unresectable cardiac cancer patients is safe and effective with relaiable short-term effect,the patient s q

关 键 词：动脉灌注化疗 贲门癌 胃左动脉 动脉留置导管 疗效 

分 类 号：R735[医药卫生—肿瘤]