胃癌局部缓释化疗与全身化疗的疗效观察

Effects of local sustained-release chemotherapy and general chemotherapy on gastric cancer

目的观察植入用5-FU缓释剂对胃癌的疗效并与常规5-FU全身化疗作对比。方法将我院1999年12月～2005年12月收治的85例胃癌手术病人分为3组,即单纯局部化疗组、单纯全身化疗组和联合化疗组。观察各组总生存率和每组早、中期肿瘤生存率及晚期肿瘤生存率,并观察每组病人化疗期间的生存质量和化疗毒副反应。结果单纯局部化疗组化疗毒副作用低,生活质量高。局部化疗组5年生存率高于全身化疗组但低于联合化疗组;将早、中期和晚期病人分开统计后发现,对早、中期胃癌,单纯局部化疗组与联合化疗组两者无统计学差异,均优于单纯全身化疗组;对晚期胃癌联合化疗效果最好。结论局部应用5-FU缓释颗粒具有疗效高、毒副作用小、对病人生活质量影响小等优势。对于早、中期胃癌病人,单纯局部缓释化疗即可;对于晚期病人,主张局部缓释化疗与全身化疗联合使用。

Objective To compare the effects of sustained-release fluorouracil and customary fluorouracil on grastric cancer. Methods Eighty-five＇cases of operated gastric cancer were divided 3 groups： local chemotherapy group（Glo）,general chemotherapy group（ Ggen） and combined chemotherapy group （Gcom）. Overall survival rate, survival rate for early-medium and advanced stage tumors were analyzed. Quality of life and side effects during chemotherapy were observed. Results The side effects were milder and quality of life better in Glo. The 5-year survival rate in Glo was higher than in Gcom, but lower than in Ggen. For early-medium stage cases, the survival rate had no significant difference between Glo and Gcom, but higher than in Ggen. The effectiveness in Gcom was the best for advanced stage cases. Condition Local sustained-release fluorouracil granule has better effect and less side-effects on gastric cancer. It also has little influence on patients＇ quality of liver. It suggests that for early-medium stage cases, sustained-release chemotherapy is performed, and for advanced cases, combined chemotherapy is recommended.