超选择胃左动脉介入化疗治疗非手术进展期胃窦癌伴癌性腹水患者的随访研究

Follow-up Study on Super-selective Left Gastric Arterial Interventional Chemotherapy for Non-operable Advanced Gastric Antrum Cancer Patients with Cancerous Ascites

目前临床上尚缺乏有效治疗非手术进展期胃窦癌伴癌性腹水患者的方法.目的：观察超选择胃左动脉介入化疗对非手术进展期胃寞癌伴癌性腹水患者的疗效及其免疫调控作用.方法：80例非手术进展期胃窦癌伴癌性腹水患者随机分为治疗组和对照组,治疗组行高剂量超选择胃左动脉介入化疗（EAP化疗方案,依托泊苷200mg/m2＋表柔比星60 mg／m2＋卡铂200 mg／m2）,对照组接受EAP静脉化疗方案.比较两组临床疗效、生活质量、免疫功能以及中位生存期、生存率.结果：治疗后,与对照组相比,治疗组肿瘤体积、癌性腹水治疗有效率、生活质量、免疫功能、中位生存期以及生存率均显著改善.不良反应发生率显著降低.结论：超选择胃左动脉介入化疗可显著提高癌性腹水的治疗有效率,改善患者的生活质量,提高中位生存期和生存率,且毒副反应低,可能与免疫功能提高有关.

Up to present, there has been no efficacious treatment for non-operable advanced gastric antrum cancer patients with cancerous ascites. Aims： To investigate the therapeutic efficacy of super-selective left gastric arterial interventional chemotherapy for non-operable advanced gastric antrum cancer patients with cancerous ascites and its modulation effect on immune function. Methods： Eighty non-operable advanced gastric antrum cancer patients with cancerous aseites were randomly divided into treatment group and control group. Patients in treatment group received high-dose super-selective left gastric arterial interventional chemotherapy （EAP regime, Etoposide 200 mg/m2＋ Epirubicin 60 mg/m2＋ Carboplatin 200 mg/m2）, while patients in control group were treated with the same chemotherapy regime by intravenous route. Clinical efficacy, quality of life, immune function, median survival time and survival rate were compared between the two groups. Results： Compared with control group, tumor volume, therapeutic efficacy of cancerous ascites, quality of life, immune function, median survival time and survival rate in treatment group improved significantly, whereas the side effects were significantly decreased. Conclusions： Super-selective left gastric arterial interventional chemotherapy can improve the therapeutic effects on cancerous aseites and patients＇ quality of life, and increase the survival time and survival rate of patients with non-operable gastric antrum cancer with less side effects. This may be related to the upregulation of immune function.