腹腔热灌注化疗对进展期胃癌术后的疗效研究

Clinical Investigation of Intraperitoneal Hyperthermic Perfusion Chemotherapy in the Treatment of Advanced Gastric Cancer

目的探讨腹腔热灌注化疗对进展期胃癌术后的临床应用价值。方法 2008年1月至2009年1月,我院消化外科纳入进展期胃癌确诊病例100例。随机分为腹化组(50例)和对照组(50例),两组均采用采用FolFox7方案:奥沙利铂(130mg/m2、第一天静脉滴注),亚叶酸钙(400mg/m2、第1天静脉滴注)和5-氟脲嘧啶(2 400mg/m2、采用第二通道、缓慢静脉滴注48h),化疗期间腹化组还采取了腹腔热灌注化疗。分别记录患者治疗前后的临床分期,并进行治疗效果评价,再分别对100例患者进行1年和两年短期随访,记录生存率和复发、转移率。结果腹化组和对照组的1年和2年生存率分别为92.0%(46/50)、80.0%(40/50)和80.0%(40/50)、64.0%(32/50)做χ2检验的统计学分析后,有统计学差异(χ2=6.62、7.10,P<0.05);局部复发率两组为16.0%(8/50)、30.0%(15/50)做χ2检验的统计学分析后,有统计学差异(χ2=5.89,P<0.05)。结论腹腔热灌注化疗治疗进展期胃癌患者,可以明显提高患者的近期生存率,降低局部复发率,毒副反应较小,临床获益较大。

Objective To investigate the clinical significance of intraperitoneal hyperthermic perfusion chemotherapy in the treatment of advanced gastric cancer.Methods Select 100 cases of patients with advanced gastric cancer,and put them into intraperitoneal chemotherapy group and control group.100 cases were given FolFox7 program： oxaliplatin（130mg/m2,the first day of infusion）,leucovorin（400mg/m2,intravenous infusion on day 1） and 5fluorouracil（2400mg/m2,using the second channel,the slow intravenous infusion of 48 hours）,during chemotherapy intraperitoneal chemotherapy group also took intraperitoneal chemotherapy.Recorded clinical stage before and after treatment,treatment evaluation,1 year and two short-term follow-up,the rate of survival,recurrence and metastasis.Results The 1 and 2-year survival rates of intraperitoneal chemotherapy group and control group were 92.0%（46/50）,80.0%（40/50） and 80.0%（40/50）,64.0%（32/50） which showed a statistically significant difference（χ2=6.62,7.10,P0.05）;two groups of local recurrence rate was 16.0%（8/50）,30.0%（15/50）,and it was a significant difference（χ2=5.89,P0.05）.Conclusion Intraperitoneal hyperthermic perfusion chemotherapy in the treatment of advanced gastric cancer patients,can significantly improve recent survival,reduce the local recurrence rate and toxicity side effects,which has greater clinical benefit.