侵犯浆膜层合并淋巴结转移胃癌术后辅助腹腔联合全身静脉化疗的生存分析

Survival of advanced gastric serosa cancer patients with lymph node metastasis after systematic intravenous chemotherapy or combined systematic and intraperitoneal chemotherapy

目的针对侵犯浆膜层合并淋巴结转移的胃癌术后患者辅助全身静脉化疗比较加用与不加用腹腔化疗的长期疗效。方法将66位患者随机分为腹腔联合静脉化疗组(治疗组)和单纯静脉化疗组(对照组),进行6周期的辅助治疗。治疗组前2周期为腹腔联合全身静脉化疗,对照组为静脉化疗。观察无病生存期(DFS)和总生存期(OS)和不良反应。结果治疗组比对照组的DFS明显延长,中位DFS分别为18.2个月和15.4个月,两组OS分别为24.7个月和25个月,无差异。结论加强局部治疗有助于延长患者的无病生存时间。总生存期的改善可能还有赖于全程疗效的提高。

Objective To compare the overall and disease-free survival of patients with advanced gastric serosa cancer （ tumor invading serosa and lymph node ） after systematic intravenous chemotherapy or combined systematic and intraperitoneal chemotherapy. Methods Sixty-six patients were randomly assigned to treatment group undergoing 6 cycles of combined systematic and intraperitoneal chemotherapy and control group receiving 6 cycles of simple systematic chemotherapy. Drugs were infused into the peritoneal cavity of patients in the treatment group for the first two cycles. Disease-free survival （DFS） and overall survival （OS） as well as side effects of drugs were observed. Results DFS of patients in the treatment group was significantly longer than that of those in the control group （18.2months vs 15.4months）. However, no difference was found in OS between the two groups （24.7months vs 25months）. Conclusion Local treatment is beneficial for DFS, and OS improves depending on the whole procedure of treatment, including surgery, first and second line chemotherapy regimens and other adjuvant therapy for advanced gastric cancer.