腹腔化疗联合全身化疗对进展期胃癌患者术后复发转移及预后的影响  

Effect of combined intraperitoneal chemotherapy and systemic chemotherapy on postoperative recurrence,metastasis,and prognosis in patients with advanced gastric cancer

作　　者：鲍双振[1] 王晓喜 王志超[2] 康政捷 刘防震[1] BAO Shuangzhen;WANG Xiaoxi;WANG Zhichao;KANG Zhengjie;LIU Fangzhen(Department of Gastrointestinal Surgery,Hengshui People's Hospital,Hengshui 053000,Hebei,China;Depart-ment of Tumor Radiotherapy,the Second People's Hospital of Hengshui,Hengshui 053000,Hebei,China)

机构地区：[1]衡水市人民医院(哈励逊国际和平医院)胃肠外科,衡水053000 [2]衡水市第二人民医院肿瘤放疗科,衡水053000

出　　处：《医学研究与战创伤救治》2025年第1期50-55,共6页Journal of Medical Research & Combat Trauma Care

基　　金：衡水市科技计划项目(2023014025Z)。

摘　　要：目的探讨腹腔化疗联合全身化疗对进展期胃癌患者术后复发转移及预后的影响。方法纳入2020年1月至2021年3月在哈励逊国际和平医院收治的200例行胃癌根治手术的III期(进展期)胃癌患者。将所有患者分为对照组(给予奥沙利铂联合替吉奥的全身化疗方案)和腹腔化疗组(在对照组患者治疗方法基础上联合腹腔化疗:腹腔灌注紫杉醇),每组100例。所有患者治疗6~8周,每个周期21 d。收集对比两组患者一般临床资料,围手术期不良反应,术后肿瘤标志物表达水平及病灶转移情况。最后,随访分析患者1年和3年患者生存率。结果腹腔化疗组患者腹痛和腹泻发生率明显高于对照组(P<0.05)。腹腔化疗组1年和3年的腹膜复发转移发生率较对照组明显降低(P<0.05)。术后两组患者肿瘤标志物CEA、CA125与CA19-9表达水平较术前明显降低(P<0.05),且腹腔化疗组患者指标水平下降程度更明显(P<0.05)。腹腔化疗组患者随访1年和3年生存率较对照组明显升高(P<0.05)。结论腹腔化疗联合全身化疗可有效降低进展期胃癌患者1年和3年的术后腹膜复发转移发生率,提高患者的预后。同时,该治疗方案安全性良好,无严重的治疗相关不良事件。这一治疗策略有望成为进展期胃癌患者术后综合治疗的重要组成部分。Objective To investigate the effects of combined intraperitoneal chemotherapy(IPC)and systemic chemotherapy on postoperative recurrence,metastasis,and prognosis in patients with advanced gastric cancer.Methods A total of 200 patients with advanced gastric cancer who underwent radical surgery at the Harrison International Peace Hospital from January 2020 to March 2021 were selected.Among them,100 patients in the control group received oxaliplatin combined with tegafur for systemic chemotherapy only,while the other 100 in the IPC group received IPC in addition to the treatment received by the control group(intraperitoneal infusion of paclitaxel).All patients were treated for 6-8 weeks with a cycle of 21 days.General clinical data,perioperative adverse reactions,postoperative tumor marker expression levels,and metastatic lesions were collected and compared between the two groups.Finally,the survival rates of patients were followed up at 1 year and 3 years.Results The incidence of abdominal pain and diarrhea in the IPC group was significantly higher than that in the control group(P<0.05).The incidence of peritoneal recurrence and metastasis at 1 and 3 years in the IPC group was significantly lower than that in the control group(P<0.05).After surgery,the expression levels of tumor markers CEA,CA125 and CA19-9 in 2 groups were significantly decreased compared with those before surgery(P<0.05),and the level of indexes in the IPC group was more significantly decreased(P<0.05).The 1-year and 3-year survival rates in the IPC group were significantly higher than those in the control group(P<0.05).Conclusion Combined IPC and systemic chemotherapy can effectively reduce the rates of postoperative peritoneal recurrence and metastasis in patients with advanced gastric cancer at 1 year and 3 years,thereby improving patient prognosis.Moreover,this treatment regimen is safe and associated with no severe treatment-related adverse events.This therapeutic strategy is expected to become an important component of comprehensive postoper

关 键 词：胃癌 腹腔化疗 复发转移 预后 

分 类 号：R735.2[医药卫生—肿瘤]