进展期胃癌术前区域动脉灌注化疗进展

Progression of preoperative regional arterial infusion chemotherapy in advanced gastric cancer

进展期胃癌的单纯手术治疗效果不理想，术后仍有较高的局部复发率和远处转移率。近年来，通过新辅助化疗减少肿瘤负荷，降低肿瘤分期，增加手术切除率，提高远期疗效，已逐步受到人们的重视。其中术前区域动脉灌注化疗直接作用于肿瘤的血管内皮细胞，局部药物浓度高。全身毒副作用小，为进展期胃癌提供了一种有效的治疗方法。本文就进展期胃癌术前区域动脉灌注化疗的适应证、并发症、疗效评价、手术时机、化疗方案及病理改变等方面进行一综述。

The outcome of surgery alone for advanced gastric cancer is unsatisfactory. Local recurrence rate and distant metastasis rate are still high in postoperative patients. In recent years, people have paid more attention to neoadjuvant chemotherapy, because it can reduce tumor loading, degrade the staging, increase the surgery excision rate and improve the long-term survival. Preoperative regional arterial infusion chemotherapy can directly act on the tumor endothelial cells with higher local drug concentration, but with fewer systemic side effects. So it may offer an effective treatment for advanced gastric cancer. The indications, complications, therapeutic evaluation, timing of surgery, chemotherapy regimens and pathomorphological changes and so on of the preoperative regional arterial infusion chemotherapy are summarized in this review.