介入治疗中晚期胃癌22例的近、中期疗效

The short-term and mid-term effect of interventional treatment for advanced gastric cancers: preliminary experience

目的 探讨介入动脉内灌注化疗及栓塞术治疗中晚期胃癌的疗效。方法 对22例活检证实为胃癌的患者行动脉内灌注化疗及栓塞治疗，4 ~ 6周治疗1次，2次治疗结束后评价疗效。结果 治疗后患者症状明显改善，上腹饱胀、疼痛缓解20/22例（90.9%），恶心、呕吐缓解12/12例（100%），腹水5例未缓解，8例粪便潜血阳性者6例缓解。总有效率为80.8％，无痊愈患者。3例介入治疗后接受手术治疗。随访6、12和24个月的生存率分别是80％、60％、20％。结论 介入灌注化疗栓塞可有效改善患者症状及降低肿瘤分期，是治疗中晚期胃癌的有效方法。

Objective To investigate the feasibility and effectiveness of interventional intra-arterial chemotherapy and embolization for the treatment of advanced gastric cancer. Methods Perfusion chemotherapy and embolization through gastric artery was carried out in 22 patients with biopsy-proved gastric cancer. The treatment was repeated after 4 - 6 weeks. The clinical results were evaluated after the second treatment. Results Remarkable improvement in clinical symptoms was observed in all patients after the treatment. Sensation of fullness and pain at epigastric area was relieved in 90.9% of patients （20/22）. Relief of nausea and vomiting was seen in 100% of patients （12/12）. No improvement in ascites was seen （n = 5）.Of eight patients with positive occult blood in stool, alleviation was obtained in 6 （75%）. The total effective rate was 80.8%（19/22）. No patient got complete cure. Surgery was performed in 3 patients after interventional treatment. The survival rates at 6, 12 and 24 months were 80%, 60% and 20% respectively. Conclusion The interventional perfusion chemoembolization therapy can effectively improve patient＇s clinical symptoms and lower the stage of the tumor. Therefore, this technique is an effective therapy for advanced gastric cancer.