胃癌围手术期腹腔热灌注化疗的临床应用

Clinical application of perioperative continuous hyperthermic peritoneal perfusion chemotherapy for gastric cancer

目的探讨胃癌围手术期(术中及术后)腹腔热灌注化疗(CHPPC)的临床意义。方法2002～2004年收治的85例进展期胃癌手术患者随机分成治疗组和对照组。治疗组44例术后采用围手术期腹腔热灌注化疗联合静脉化疗,对照组41例只行术后静脉化疗,比较两组的术后并发症、毒副反应、局部复发率、远处转移率、1及3年生存率。结果两组间术后并发症及毒副反应无显著性差异。治疗组的局部复发率、远处转移率分别为20.45%和15.90%,低于对照组的43.90%及39.02%,差异均具有显著性(P<0.05);治疗组1和3年生存率分别为90.90%和59.09%,高于对照组的78.05%和34.15%,差异均具有显著性(P<0.05)。结论胃癌围手术期热灌注化疗安全可行,可显著减少局部复发率、远处转移率,提高生存率。

Objective To evaluate the clinical effect of intraoperative and early postoperative continuous hyperthermic pertioneal perfusion chemotherapy （CHPPC） for gastric cancer： Methods Eight-five patients with gastric cancer were randomized into therapeutic group with perioperative CHPPC combined with intravenous chemotherapy （n=44） and control group with intravenous chemotherapy only （n=41）. The postoperative complications, adverse effects, local recurrence rates, distant metastasis rates, and 1- and 3-year survival rates were compared between two groups. Results, No significant differences were found in the postoperative complications and adverse effects between th6 two groups. The recurrence rate and distant metastasis rates in the therapeutic group were significantly lower than those in the control group （20.45% vs 43.90%, and 15.90% vs 39.02%, P〈0.05）. The 1- and 3-year survival rates in the therapeutic group were significantly higher than those in the control group （90.90% vs 78.05%, and 59.09% vs 34.15%, P〈0.05）. Conclusion Perioperative CHPPC for gastric cancer is safe and feasible, and can reduce the recurrence rate, distant metastasis rate and improve the survival for gastric cancer patient after operation.