进展期胃癌术中应用氟尿嘧啶缓释剂间质化疗的临床疗效

Efficacy and Safety of Intraoperative Mesenchymal Chemotherapy with 5-Fluorouracil Release Formulation in Radical Gastrectomy of Advanced Gastric Cancer

目的评价进展期胃癌根治术中植入5-FU缓释剂间质化疗的临床疗效和安全性。方法 102例进展期胃癌患者(术前均经胃镜和病理检查确诊)随机分为治疗组和对照组,各51例。2组均行D2根治术,治疗组在手术结束时局部植入5-FU缓释剂进行间质化疗,术后4周进行6个周期常规化疗;对照组术中不进行腹腔内干预性治疗,术后化疗方案同治疗组。结果 2组患者的腹腔引流量、白细胞水平、白蛋白水平及消化道不良反应方面的差异均无统计学意义(P>0.05);中位随访时间为28个月,治疗组肿瘤局部复发率低于对照组(16.3%比39.1%,P<0.05),治疗组术后3年的总生存率高于对照组(85.8%比67.3%,P<0.05)。结论进展期胃癌行D2根治术时植入5-FU缓释剂进行间质化疗无明显不良反应,能减少局部复发率,提高患者生存率,是治疗胃癌行之有效的方法。

Objective To evaluate the efficacy and safety of intraoperative mesenchymal chemotherapy with 5-FU implants in radical gastrectomy of advanced gastric cancer.Methods From January 2008 to September 2009,102 patients with historically proven advanced gastric cancer were enrolled in our department and were allocated to undergo either radical gastrectomy and intraoperative mesenchymal chemotherapy with 5-FU implants 800 mg（treatment group,n=51）,or radical gastrectomy alone（control group,n=51）.The postoperative complications and recurrence rate between two groups were compared.Results There were no significant differences on the volume of abdominal cavity drainage,count of white blood cells,albumin level,and gastrointestinal adverse events between the two groups（P 0.05）.After a median follow-up of 28 months,the local recurrence rate was lower among patients in treatment group than that in control group（16.3% vs.39.1%,P 0.05）,the survival rate of 3-year was higher in treatment group than that in control group（85.8% vs.67.3%,P0.05）.Conclusions Compared with the control group,there are no significant adverse reactions on patients with advanced gastric cancer who were implanted fluorouraci1 implants during operation,which can reduce local recurrence rates and improve the survival rates.