不同剂量洛铂在胃癌术中腹腔化疗的临床分析  

Application of intraoperative intraperitoneal chemotherapy with different doses of lobaplatin for gastric cancer

作　　者：谢海伟[1] 朱斌[1] 陶平[1] XIE Haiwei;ZHU Bin;TAO Ping(Department of General Surgery,Affiliated Nanjing Hospital of Nanjing Medical University,Nanjing First Hospital,Nanjing 210006,China)

机构地区：[1]南京医科大学附属南京医院,南京市第一医院普外科,南京210006

出　　处：《临床肿瘤学杂志》2023年第5期432-436,共5页Chinese Clinical Oncology

摘　　要：目的探讨不同剂量洛铂在胃癌术中腹腔化疗的安全性和疗效。方法选取2016年10月至2018年10月因进展期胃癌入院的85例患者,随机分成两组,均接受D_(2)胃癌根治术及术后奥沙利铂联合替吉奥化疗。其中高剂量组40例,术中用洛铂50 mg/m^(2)腹腔化疗,低剂量组45例,术中用洛铂30 mg/m^(2)腹腔化疗。观察两组的不良反应及术后恢复情况;比较两组患者的复发及生存情况。结果两组均顺利完成手术。不良反应方面,术后高剂量组腹痛发生率高于低剂量组(P<0.05);两组骨髓抑制、转氨酶升高、恶心呕吐等发生率比较,差异无统计学意义(P>0.05);两组吻合口瘘、腹腔感染、切口感染、肠梗阻等并发症发生率比较,差异均无统计学意义(P>0.05)。高剂量组2年生存率为82.5%,高于低剂量组的73.3%,但差异无统计学意义(P>0.05);高剂量组2年无复发生存率为75.0%,明显高于低剂量组的53.3%,差异有统计学意义(P<0.05)。结论与低剂量组相比,高剂量洛铂用于胃癌术中腹腔化疗,具有较高的安全性和更高的无复发生存率。Objective To study the safty and effect of intraoperative intraperitoneal perfusion chemotherapy with different doses of lobaplatin for gastric cancer.Methods Eighty-five patients with advanced gastric cancer were divided into high-dose group(n=40)and low-dose group(n=45)in our hospital from October 2016 to October 2018.Two groups of patients underwent D_(2) radical operation for gastric cancer and received postoperative chemotherapy of oxaliplatin and S-1.Intraoperative intraperitoneal injection with 50 mg/m^(2) lobaplatin was performed in the high-dose group,and 30 mg/m^(2) lobaplatin was performed in the low-dose group.The recurrence-free and overall survival rates of the patients after surgery were compared between the two groups.Results All patients successfully completed the operation.The incidence of abdominal pain after surgery was higher in the high-dose group than in the low-dose group(P<0.05),but there was no statistically significant difference between the two groups in terms of bone marrow suppression,elevated transaminase,nausea and vomiting(P>0.05).The incidence of anastomotic leakage,abdominal infection,incision infection,and intestinal obstruction was no significant difference(P>0.05).The 2-year survival rate of the high-dose group was 82.5%,which was higher than 73.3%of the low-dose group,but the difference was not statistically significant(P>0.05).The 2-year recurrence-free survival rate of the high-dose group was 75.0%,wihich was significantly higher than 53.3%of the low-dose group,with a statistically significant difference(P<0.05).Conclusion Intraoperative local injection with high-dose lobaplatin is safe in the treatment of advanced gastric cancer and has higher recurrence-free survival rate compared with low-dose group.

关 键 词：胃癌 洛铂 腹腔化疗 剂量 

分 类 号：R735.2[医药卫生—肿瘤]