改良DCF方案腹腔灌注热疗与ECF方案在晚期胃癌治疗中的疗效对比分析

Comparison of efficiency between DCF modifications by intraperitoneal hyperthermic perfusion chemotherapy and ECF regimen in advanced gastric cancer

目的观察改良DCF方案(mDCF)腹腔灌注射频热疗对晚期胃癌的疗效和不良反应。方法对30例病理组织学确诊的晚期胃癌患者进行研究,随机分为两组。改良DCF方案腹腔灌注热疗组(简称mDCF腹灌热疗组)15例,化疗方案为多西他赛(艾素)40 mg/m2,静脉滴注,第1天;亚叶酸钙400 mg/m2,静脉滴注,第1天;5-Fu 400 mg/m2,静脉冲入,第1天;5-Fu 1000 mg/m2持续泵入46 h第1、第2天;顺铂40 mg/m2加入44℃生理盐水1500～2000 ml中,行腹腔灌注,然后腹腔射频热疗1.5 h,温度42～43℃。14 d为1个治疗周期。ECF方案组(以下简称ECF组),表柔比星60 mg/m2,静脉冲入,第1天;5-FU 600 mg/m2,持续静脉泵输注120 h;顺铂20 mg/m2,静脉滴注,第1～3天。21 d为1个周期。治疗前后进行KPS评分,2个周期治疗后评价疗效。结果 mDCF腹灌热疗组15例中CR 3例,PR 5例,SD 5例,PD 2例,有效率(CR+PR)53.33%,ECF组CR 1例,PR 3例,SD 7例,PD 4例,有效率(CR+PR)26.67%。组间有效率比较差异有统计学意义(P<0.05)。治疗不良反应主要为骨髓抑制、消化道反应等,不良反应程度组间差异有统计学意义(P<0.05)。治疗后mDCF腹灌组和ECF组KPS评分分别为(83.52±5.49)分、(79.96±7.6)分,组间差异有统计学意义(P<0.05)。结论 mDCF腹腔灌注热疗对晚期胃癌有一定疗效,不良反应较轻,患者生活质量有明显改善。

Objective To observe the effect of combination of DCF modifications（mDCF） and cisplatin in intraperitoneal hyperthermic perfusion chemotherapy in patients with advanced gastric cancer.Methods Fifteen patients were treated with combination of docetaxel（40 mg per square meter）,leucovorin（400 mg per square meter） intravenous injection over 2 h,a 5-fluorouracil（400 mg per square meter） intravenous injection bolus,and 5-fluorouracil（1000 mg per square meter） intravenous injection over 46 h plus cisplatin（40 mg per square meter） intraperitoneal hyperthermic perfusion.15 patients were treated with combination of ECF regimen.Results Compared to ECF regimen,the rseponse rate in the group of mDCF plus intraperitoneal hyperthermic perfusion was significantly increased,53.33% and 26.67 % respectively.The main side-effects were myelosuppression and gastrointestinal reaction,and the grade difference between two groups was significant.The KPS score after cheotherapy was higher in the group of mDCF plus intraperitoneal hyperthermic perfusion than that of ECF regimen,（80.67±7.98） and（74.00±9.10） respectively,there was a significant difference between the two groups（P＆lt;0.05）.Conclusion mDCF plus intraperitoneal hyperthermic perfusion performed efficientily in advanced gastric cancer with less side-effects.