胃癌术后腹腔化疗疗效对比分析及评价

Analysis and evaluation for the effect of postoperative introperitoneal chemotherapy in gastric cancer

目的:评价胃癌术后腹腔化疗的疗效及其与胃癌生物学行为的相关性。方法:将1996年1月～2000年7月中国医科大学第一附属医院肿瘤科收治的进展期胃癌275例,分为根治切除组和姑息切除或探查组,再分别根据是否进行腹腔化疗分成实验组(128例)与对照组(147例),实验组行温热腹腔化疗,对照组未做腹腔化疗。应用Kaplan-Meier生存曲线分析两组各年生存率的差别,利用字2检验分析腹腔化疗对相同胃癌生物学行为类型病例近期生存率的影响。结果:Kaplan-Meier生存曲线显示腹腔化疗能有效提高胃癌根治性切除病例的1、3年生存率,分别提高13.8%和20.5%,中位生存期延长22个月,即使是生物学行为差的病例,腹腔化疗亦能提高其生存时间。本组晚期胃癌行姑息性切除术后病例的中位生存期提高了8个月,延长了生存时间。结论:腹腔化疗是进展期胃癌手术治疗后有效的辅助疗法。

Objective: To evaluate the effect of postoperative introperitoneal chemotherapy and the relationship between intraperitoneal chemotherapy (IPC) and biological behavior of gastric cancer. Methods: Two hundred and seventy-five cases of gastric cancer were divided into the test team (128 cases) and the contrast team (147 cases) due to IPC or not. in test team, 43℃ saline 1000ml+5-Fu 750mg+CBP 400mg or DDP 40～50mg are dripped into the peritoneal cavity of each patient every two weeks, totally 2～4 times. The patients of contrast didn't have IPC. The Kaplan-Meier survival curve was used to analyze the difference of the survival time between the test team and the contrast team and χ2 test was used to evaluate the effect of IPC in the same type of biological behavior. Results: The Kaplan-Meier survival curve analysis showed that IPC prompted the 1-year survival rate (13.8%) and the 3-year survival rate (20.5%) of test team contrary to the contrast team after radical operations. The median survival time was prompted from 30 months to 52 months. IPC prompted the survival time of the cases who have poor biological behavior of gastric cancer. Besides, IPC prolonged 8 months for the median survival time the median survival time 8 months in the cases who had palliative operations. Conclusion: IPC is an effective postoperative adjuvant treatment to advanced gastric cancer.