术中动脉灌注化疗联合术野5-氟尿嘧啶缓释剂植入预防进展期胃癌术后肝脏转移及局部复发的疗效研究

Effect study of operative artery infusion chemotherapy combined with 5-fluorouracil sustained-release implanted in surgical field in the prevention of postoperative liver metastasis and local recurrence of advanced gastric carcinoma

目的研究进展期胃癌术中肝固有动脉灌注化疗联合术野5-氟尿嘧啶缓释剂(中人氟安)植入对预防术后胃癌肝转移及局部复发的作用。方法将2005～2009年笔者所在医院收治的80例进展期胃癌患者,随机分为实验组40例患者,治疗方案为术中区域灌注化疗联合D2根治手术及中人氟安植入,对照组40例患者,治疗方案为单纯D2根治手术。术后两组均予常规相同化疗治疗。治疗后随访3年。结果比较两组患者术后并发症的发生率及1年、2年生存率,差异无统计学意义(P>0.05)。肝脏转移率、局部复发率、3年生存率实验组明显低于对照组,差异具有统计学意义(P<0.05)。结论进展期胃癌术中区域性动脉灌注化疗联合术野中人氟安植入可明显降低术后肝脏转移发生率及局部复发率,提高患者远期生存率,且不良反应轻,安全可行。

Objective To study the value of operative proper hepatic artery infusion chemotherapy combined with surgical field 5-fluorouracil sustained-release （sinofuan） implanted in advanced gastric cancer in the prevention of postoperative gastric cancer liver metastasis and local recurrence.Methods 80 cases of advanced gastric cancer patients in author＇s hospital from 2005 to 2009 were randomly divided into experimental group with 40 cases by using operative artery infusion chemotherapy,D2 radical surgery and sinofuan implanted as therapy,and control group with 40 cases taking pure D2 radical surgery as therapy,had postoperative routine the same chemotherapy.A 3-year follow-up after treatment has been taken.Results Two groups were compared the incidence of postoperative complications and one year,two-year survival rate was not statistically significant,the rate of liver metastasis,local recurrence rate,three-year survival rate of experimental group was significantly lower than the control group,with statistical significance.Conclusion Intraoperative artery infusion chemotherapy combined with surgical field sustained-release 5-fluorouracil（sinofuan） implanted in advanced gastric cancer can significantly reduce the postoperative liver metastasis incidence and local recurrence,improve patients＇long-term survival.It was safe and feasible.