胃左动脉介入灌注化疗治疗晚期贲门癌的临床观察

Observation on clinical efficacy of left gastric arterial infusion chemotherapy in treatment of advanced gastric cancer

目的探讨经胃左动脉介入灌注化疗治疗晚期贲门癌的近期疗效和2年生存率。方法将2008年10月至2010年4月间收治的88例晚期贲门癌患者随机单盲分为观察组(45例)和对照组(43例),观察组患者采用胃左动脉介入灌注DCF化疗方案,对照组患者采用常规静脉输注DCF化疗方案,两组均用药3个周期,记录化疗期间两组患者的不良反应,化疗结束后1个月内对比两组患者的近期疗效,并进行为期2年的随访观察,记录2年生存率。结果 (1)化疗结束后1个月时,观察组患者完全缓解(CR)2例,部分缓解(PR)25例,总有效率为60.0%(27/45);对照组完全缓解0例,部分缓解(PR)17例,总有效率为39.5%(17/43),差异有统计学意义(P<0.05)。(2)观察组患者Ⅱ度以上骨髓抑制、肝功能损害、末梢神经损害和胃肠道反应比例低于对照组(28.9%和51.2%、17.8%和39.5%、15.6%和34.9%、42.2%和67.4%),差异均有统计学意义(均P<0.05);(3)观察组患者2年随访期内死亡者平均存活时间为(15.1±2.9)个月,长于对照组的(13.3±2.4)个月,差异有统计学意义(P<0.05)。结论经胃左动脉介入灌注化疗药物较全身化疗能有效提高近期疗效,降低不良反应,并延长患者生存时间。

Objective To explore the short-term clinical effect and 2 years prognosis of chemotherapy in treatment of advanced cardiac carcinoma by left gastric arterial infusion method.Methods 88 admitted advanced cardiac cancer patients ranging from October 2008 to April 2010 were randomly divided into observation group（45 cases） and control group（43 cases）,cases in observational group were treated by DCF chemotherapy regimen through left gastric arterial infusion,and cases in control group were applied DCF regimen through conventional intravenous infusion,both 2 gorups were treated by 3 cycles,during of which adverse drug reactions were noted,and short-term clinical efficacy were compared within 1 month after the end of chemothreapy,besides,2 years following-up study was conducted to note survival rate and meal survival months.Results（1） The observation group complete remission（CR） in 2 cases,partial remission（PR） in 25 cases,the RR was 60.0%（27/45）,the control group CR in 0 case,PR in 17 cases,the RR was 39.5%,the difference was statistically significant（P0.05）;（2）Observation group whose Ⅱ degree bone marrow suppression,liver damage,peripheral nerve damage,gastrointestinal reaction ratio were lower than those of control group（28.9% and 51.2%,17.8% and.39.5%,15.6% and 34.9%,42.2% and 67.4%）,and the difference was statistically significant（P 0.05）;（3）Patients of 2 groups died of cardiac cancer whose mean survival time were（15.1±2.9）months and（13.3±2.4）months respectively,and there was statistically significant（P 0.05）.Conclusions The left gastric arterial infusion chemotherapy scheme compared with systemic chemotherapy can effectively improve short-term clinical efficacy,reduce adverse reaction,and prolong patients＇ survival period.