顺铂和丝裂霉素腹腔内化疗治疗胃癌术后腹膜转移疗效观察

Efficacy of intraperitoneal chemotherapy with cisplatin and/or mitomycin C in treatment of peritoneal dissemination from postoperative gastric carcinoma

目的评价腹腔化疗对胃癌术后腹膜转移患者腹腔冲洗细胞学转阴率及对生存期的影响。方法2003至2005年共收治16例胃癌腹膜种植及8例腹腔冲洗细胞学(P0Cy+)患者,于术中留置腹腔化疗管,定期灌注顺铂(CDDP)、丝裂霉素(MMC),平均灌注次数5.6次,CDDP总量为288mg。结果化疗后腹腔冲洗细胞学转阴率为71.4%,P0Cy+组转阴率更高;治疗后转阴组的中位生存时间(777d)和无效组(254d)相比明显延长,化疗副作用包括腹胀、腹泻、恶心、呕吐、肝肾功能损害、骨髓抑制。结论本疗法对于胃癌腹膜种植高危人群、P0Cy+患者疗效显著。

Objective To evaluate the effect of intraperitoneal chemotherapy on survival and negative change of peritoneal washing cytology in patients with peritoneal dissemination from postoperative gastric carcinoma. Methods Intraperitoneal chemotherapy（IC） via IP port was carried out in 16 patients with peritoneal dissemination （ P ＋ ） and 8 with positive washing cytology （ P0Cy ＋ ）. Cisplatin（CDDP） with mitomycin（MMC） dissolved in physiological saline was perfused intraperitoneally for 5. 6 times and the average total dose of CDDP was 288.0 mg. Results Negative change of washing cytology after IC was found in 71%, especially with high rate in P0Cy（ ＋ ） cases. The median survival time （MST） of respenders inereased to 777days as compered with 254 days in ineffective group. The side effects included adbominal distension diarrhea,nausea,vomiting, dysfunction of liver and kidney. Conclusion IC is effective for peritoneal disseminationfrom gastric carcinoma, especially for P0cy（ ＋ ） cases .