胃肠道癌术后腹腔静脉双途径化疗临床研究

Clinical Observation of Postoperative Intraperitoneal Combined with Intravenous Double Chemotherapy in Patients with Digestive Malignancies

目的探讨腹腔内温热淋巴化疗联合静脉双途径化疗对提高生存率及防治腹膜复发和淋巴转移的作用。方法38例侵及浆膜或有腹腔淋巴结转移的胃肠癌患者术后行温热腹腔淋巴化疗(腹腔化疗同时静脉点滴垂体后叶素)联合全身化疗(治疗组);42例仅予温热腹腔内化疗+全身化疗(对照组)而未行腹腔淋巴化疗。结果治疗组患者1,2,3年生存率分别为97.4%,86.7%,78.9%;对照组为83.3%,73.8%,64.2%。治疗组患者1,2,3年生存率明显优于对照组,2组差异有统计学意义(P<0.05)。治疗组患者3年内腹膜复发率15.3%,淋巴结转移率为18.4%,明显低于对照组42.1%,38.1%,2组差异有统计学意义(P<0.05)。结论温热腹腔淋巴化疗联合静脉双途径化疗可降低胃肠道肿瘤术后腹腔内及腹膜后淋巴转移率,提高术后生存率。

Objective To evaluate the effect of intraperitoneal hyperthermia lymph chemotherapy combined with intravenous chemotherapy on increasing survival rate and preventing the peritoneal recurrence and lymph node involvement. Methods 38 patients of advanced digestive malignancies with peritoneal involvement and intraperitoneal lymph node metastasis were treated by intraperitoneal hyperthermia lymph chemotherapy combined with intravenous systemic chemotherapy（ treated group） and another 42 cases treated with intraperitoneal hyperthermia chemotherapy combined with intravenous systemic chemotherapy alone as con- trol. Results The 1-,2- and 3-year survival rates of the treated group were 97.4% ,86.7% and 78.9% respectively, while the rates of the control group were 83.3% ,73.8% and 64.2% respectively. The 1-,2- and 3-year survival rate of the treated group was higher than that of the control group（ P 〈 0.05 ）. The 3-year peritoneal recurrent（ 15.3% ） and lymph node involvement （ 18.4% ） of the treated group was markedly lower than that（42.1% ,38.1% ） of the control group（ P 〈0.05 ）. Conclusions Adjuvant intraperitoneal hyperthermia lymph chemotherapy combined with intravenous double chemotherapy of digestive malignancies is effective and can increase postoperative survival rate.