区域灌注加腹腔低渗热化疗预防胃癌术后复发和转移的临床研究

Clinical Study of Regional Infusion Combined with Hypotonic Intraperitoneal Chemohyperthermia for Prevention of Recurrence and Metastasis after Radical Resection of Gastric Carcinoma

目的探讨区域灌注加腹腔低渗热化疗对预防胃癌术后复发和转移的价值。方法将136例实行根治术的胃癌患者随机分成两个组。治疗组(68例):术后行区域动脉灌注化疗加腹腔低渗热化疗;对照组(68例):术后行全身静脉化疗,比较两组疗效。结果随访5年,治疗组1、3、5年生存率分别为94.1%(64/68)、77.9%(53/68)、54.4%(37/68);对照组分别为75.0%(51/68)、51.5%(35/68)、29.4%(20/68)。治疗组局部复发率、腹膜转移率、肝转移率和骨髓抑制发生率分别为10.3%(7/68)、19.1%(13/68)、22.1%(15/68)、17.6%(12/68);对照组分别为25.0%(17/68)、45.6%(31/68)、47.1%(32/68)、36.8%(25/68)。两组指标比较,有非常显著性差异(P<0.01)。结论区域动脉灌注化疗结合腹腔低渗热化疗能有效防治胃癌术后局部复发和腹膜转移、肝转移,疗效好于全身静脉化疗,且副作用小。

Objective To evaluate the value of regional infusion chemotherapy combined with hypotonic intraperitoneal chemohyperthermia for prevention of recurrence and metastasis after radical resection of gastric carcinoma. Methods 136 patients with gastric carcinoma undergoing radical operation were randomly divided into 2 groups： Treatment group（68cases） were given regional infusion chemother- apy and hypotonic intraperitoneal chemohyperthermia; Control group （68cases） were given venous chemotherapy. Results All the cases were followed for 5 years, the 1.3.5-year survival rate ： the treatment group was 94. 1% （64/68） .77. 9% （53/68）. 54. 4% （37/68） ~ the control group was 75.0% （51/68）. 51.5% （35/68） .29.4% （20/68）. The local recurrence rate.intraperitoneal implantation rate. hepatic metastasis rate and marrow restrain rate： the treatment group was 10.3% （7/68）.19.1%（13/68）.22.1% （15/68）.17. 6%（12/68）; the control group was 25. 0% （17/68）.45. 6% （31/68）.47. 1% （32/68）. 36.8%（25/68）. Conclusions Regional infusion chemotherapy combined with hypotonic intraperitoneal chemohyperthermia is effective for prevention of recurrence and metastasis after radical resection of gastric carcinoma. It has better effect than venous chemotherapy and has lower toxic side effects.