热疗联合化疗治疗晚期胃癌患者的疗效和安全性研究

Study on efficacy and safety of hyperthermia combined with chemotherapy in the treatment of patients with advanced gastric cancer

目的：研究热疗联合化疗治疗晚期胃癌的安全性及近远期疗效。方法选择2010年3月至2013年3月解放军169医院收治的晚期胃癌患者77例，随机分为热化疗联合组39例和单纯化疗组38例。给予2个周期治疗后，对2组患者疗效及生活质量进行评定，同时观察并统计两组患者治疗期间不良反应发生情况。结果治疗结束后单纯化疗组有效率为34.2％(13/38)，低于热化疗联合组的59.0%（23/39），两组比较差异有统计学意义（P<0.05）；热化疗联合组患者远期生存率与单纯化疗组比较差异未见统计学意义（P<0.05）；两组患者发生的不良反应主要有骨髓抑制、肝肾损害、胃肠道反应及周围神经毒性反应等，两组患者不良反应发生率比较差异均无统计学意义（P>0.05）。治疗结束后热化疗联合组患者的生活质量评分在精神健康、躯体疼痛、生理职能以及总体健康项目的得分均优于单纯化疗组，差异均有统计学意义（均 P<0.05）。结论晚期胃癌患者采用热疗有利于增强化疗作用，该方案安全性高，可以在临床中推广使用。

Objective To explore the safety and synergistic efficacy of hyperthermia and chemotherapy in the treatment of advanced gastric cancer. Methods From March 2010 to March 2013,77 patients with advanced gastric cancer were randomly assigned to a synergistic group which received chemotherapy combined with hyperthermia or to a control group which only received chemotherapy. After 2 treatment cycles, efficacy and the quality of life were compared between those two groups, and side effects were recorded during the treatment. Results The response rate was 34.2% (13/38) in the control group, which was significantly lower than 59.0% (23/39) in synergistic group (P<0.05). There were no significant difference with the overall survival between those two groups (P>0.05). The main adverse reactions included bone marrow depression, liver and kidney damage, gastrointestinal reactions and peripheral nerve toxicity. There were no significant difference with the adverse reaction rate between those two groups (P>0.05). After the treatment, a part of items in the life quality scoring were significantly higher in synergistic group than that in the control group (P<0.05). Conclusion Hyperthermia might improve the therapeutic effect of chemotherapy in advanced gastric cancer with high safety, which can be clinically applied.