双路化疗治疗胃肠道恶性肿瘤临床研究

目的观察腹腔温热灌注(Intraperitoneal hyperthermic perfusion,IPHP)联合全身化疗治疗中晚期胃肠道恶性肿瘤的疗效及其不良反应。方法分析162例手术后中晚期胃肠道恶性肿瘤患者资料,其中IPHP联合全身化疗76例(联合组)和全身化疗86例(单纯化疗组),比较2组病人的疗效及其不良反应。结果近期疗效:联合组27例Ⅳ期患者中CR6例,PR9例,有效率为55.56%;单纯化疗组34例Ⅳ期患者中CR3例,PR6例,有效率为26.47%(P<0.05)。远期疗效:3年生存率联合组为77.63%,单纯化疗组为63.95%(P>0.05);5年生存率联合组为68.42%,单纯化疗组为37.21%(P<0.05)。2组病人不良反应差异无统计学意义。结论腹腔温热灌注联合全身化疗治疗中晚期胃肠道恶性肿瘤的疗效优于单纯全身化疗,不良反应相似,值得临床推广应用。

Objective To evaluate the therapeutic efficacy and side effects of two route chemotherapy：intraperitoneal hyperthermic perfusion（IPHP） combined with systemic chemotherapy for patients with intermediate and late gastrointestinal carcinoma.Methods 162 patients with intermediate and late gastrointestinal carcinoma being surgically resected 3～4 weeks previously were recruited and divided into two groups,IPHP combined with systemic chemotherapy group（therapeutic group）and systemic chemotherapy group（control group）.The therapeutic efficacy and side effects of the two groups were recorded and compared.Results After 2-3 cycles,there were 6CR,9PR in the stageⅣgastrointestinal carcinoma of therapeutic group,the response rate was 55.56%;there were 3CR,6PR in the stageⅣgastrointestinal carcinoma of control group,the response rate was 26.47%（P0.05）.3-year survival rate of the therapeutic group was 77.63%while that of the control group was 63.95%（P0.05）;5-year survival rate of the therapeutic group was 68.42%while that of the control group was 37.21%（P0.05）.There were no significant differences in the side effects between two groups.Conclusion Therapeutic efficacy of intraperitoneal hyperthermic perfusion combined with systemic chemotherapy is superior to systemic chemotherapy among patients with intermediate and late gastrointestinal carcinoma,but side effects between two groups show similiar.The treatment is worthy to be further applied in clinical practice.