腹腔热灌注化疗治疗胃癌腹膜转移患者的预后分析及安全性评价  

Prognostic analysis and safety of hyperthermic intraperitoneal chemotherapy in gastric cancer patients with peritoneal metastases

作　　者：黄超 石浩冬 张恒 黄博[1] Chao Huang;Haodong Shi;Heng Zhang;Bo Huang(Department of General Surgery,The Fifth Clinical College of Shanxi Medical University,Taiyuan 030000,China)

机构地区：[1]山西医科大学第五临床医学院普通外科,太原市030000

出　　处：《中国肿瘤临床》2023年第14期703-707,共5页Chinese Journal of Clinical Oncology

摘　　要：目的:探讨腹腔热灌注化疗(hyperthermic intraperitoneal chemotherapy,HIPEC)对胃癌腹膜转移[腹膜癌指数(peritoneal cancer index,PCI≤7)]患者预后及术后并发症的影响。方法:回顾性分析2019年1月至2021年1月就诊于山西医科大学第五临床医学院的124例胃癌腹膜转移(PCI≤7)患者的临床资料,根据是否行HIPEC将患者分为干预组和对照组,并对患者进行随访。采用Cox分析方法探究HIPEC与患者术后生存率的关系;Kaplan-Meier方法绘制生存曲线,采用Log-rank检验法进行组间生存率对比;χ2检验分析HIPEC对患者生活质量及术后并发症发生情况的影响。结果:干预组1年、2年累积生存率分别为92.1%、81.2%;对照组分别为75%、63.3%。干预组1年(P=0.011)、2年(P=0.024)总体生存率明显高于对照组,差异有统计学意义。Cox多因素分析结果提示HIPEC可以降低胃癌腹膜转移患者的死亡风险(P=0.004),2年死亡风险降低为对照组的0.341倍。两组之间生活质量卡氏评分(KPS)提高水平无显著差异(P=0.602)。HIPEC降低了发热并发症出现的概率(P<0.05),其他并发症无显著差异。结论:HIPEC在不影响患者生活质量的前提下明显提高胃癌腹膜转移(PCI≤7)患者的1年、2年生存率,且不增加术后并发症的发生风险。Objective:To investigate the influence of hyperthermic intraperitoneal chemotherapy(HIPEC)on the prognosis and postoperative complications in patients with peritoneal metastases of gastric cancer[peritoneal cancer index(PCI)≤7].Methods:One hundred and twenty-four patients diagnosed with metastases of gastric cancer at The Fifth Clinical College of Shanxi Medical University from January 2019 to January 2021 were enrolled in this study.Their clinical characteristics were recorded and retrospectively analyzed.These patients were then assigned into two groups(intervention and control)according to whether suffering HIPEC.The prognosis of all the patients was followed.Kaplan-Meier and Cox multivariate analyses were performed to explore the impact of HIPEC on the survival rate of patients with gastric cancer.χ2 test was used to analyze the relationship between HIPEC and patients'quality of life and the occurrence of postoperative complications.Results:The 1-and 2-year cumulative survival rates of the intervention group were 92.1%and 81.2%,respectively,which were significantly higher than those of the control group(75%and 63.3%,respectively).Cox multivariate analysis suggested that HIPEC reduced the mortality risk,and the 2-year risk of death was reduced to 0.341 times that of the control group.There was no significant difference in the level of postoperative quality of life improvement measured using Karnofsky score(KPS)between the two groups(P=0.602).HIPEC reduced the probability of febrile complications(P<0.05).There was no statistically significant difference between the two groups in terms of other postoperative complications.Conclusions:HIPEC significantly improves the prognosis of patients with gastric cancer and peritoneal metastasis,without increasing the risk of complications or damaging the postoperative quality of life.

关 键 词：胃癌 腹膜癌 腹腔热灌注化疗 预后 

分 类 号：R735.2[医药卫生—肿瘤]