胃癌术后腹腔化疗和静脉化疗的疗效比较

Comparison of the effectiveness of postoperative intravenous chemotherapy and intraperitoneal chemotherapy for advanced gastric cancer

目的 比较进展期胃癌术后腹腔化疗和静脉化疗的临床疗效。方法 将 68例进展期胃癌术后化疗按前瞻、随机、对照的原则分为治疗组 (腹腔化疗 ) 3 3例及对照组 (静脉化疗 ) 3 5例 ,比较两组治疗的不良反应发生率、腹腔内复发率、肝转移率、3年生存率的差异。结果 治疗组胃肠反应率、骨髓抑制率、腹腔内复发率、肝转移率、3年无瘤生存率、3年生存率分别为 12 .1%、9.0 %、18.1%、12 .1%、2 3 .6%、5 4.5 %。对照组胃肠反应率、骨髓抑制率、腹腔内复发率、肝转移率、3年无瘤生存率、3年生存率分别为 91.3 %、85 .7%、60 .0 %、3 7.1%、12 .8%、3 4.3 %。结论 与静脉化疗比较 ,进展期胃癌术后腹腔化疗的不良反应发生率、腹腔内复发率、肝转移率、3年生存率率降低 ,差异有显著性 (P <0 .0 5 )。

Objective To compare the clinical effectiveness of postoperative intravenous chemotherapy and intraperitoneal chemotherapy for advanced gastric cancer.Methods Sixty-eight postoperative patients with advanced gastric carcinoma were divided into two groups:treatment group receiving intraperitoneal chemotherapy(n=33) and control group subject to intravenous chemotherapy(n=35).The incidence of side-effects,intraperitoneal recurrence rate, hepatic metastatic rate and 3-year survival rate were compared between the two groups.Results Vomit,marrow restrain and the local and hepatic recurrence,3 year disease-free survival rate and 3 year overall survival rate in the treatment group were 12.1%,9.0%,18.1%,12.1%,23.6% and 54.5% respectively,while those in the control group were 91.3%,85.7%,60.0%,37.1%,12.8% and 34.3%,respectively (all P<0.05).Conclusion Intraperitoneal chemotherapy is an effective way to prevent side-effect and the local and hepatic recurrence after advanced gastric carcinoma operation.