活性碳吸附丝裂霉素C腹腔化疗的临床实验研究

Prophylaxis and Treatment of Postoperative Peritoneal Carcinomatosis:An Animal Experiment and Clinical Practice of Intraperitoneal Chemotherapy with Mitomycin C Bound Activated Carbon Particles

目的：通过动物实验及临床应用，证实活性碳吸附丝裂霉素Ｃ腹腔化疗能治疗和预防进展期胃癌术后腹腔复发，从而提高患者的生存率。方法：利用人胃癌裸鼠模型进行活性碳（ＣＨ）吸附ＭＭＣ腹腔化疗的动物实验，共分４组，每组８只荷瘤裸鼠。实验组腹腔给予ＣＨ－ＭＭＣ，腹腔化疗组腹腔给予ＭＭＣ，静脉化疗组经内眦静脉给予ＭＭＣ，对照组腹腔注入等容量生理盐水。

Objective An animal experiment and clinical practice have demonstrated a beneficial effect of intraperitoneally applied mitomycin bound to activated carbon particles MMC－CH in prevention and treatment of intraabdominal recurrence following curative surgery for gastric cancer． Methods An animal experiment on rude mice with the model of human gastric cancer in 4 groups MMC－CH group MMC group MMC－Ⅳ group and control group was completed to check the effect of prophylaxis and treatment of intraperitoneal carcinomatosis． A total of 68 patients with a radically resected gastric cancer infiltrating the serosal surface were randomly assigned to receive either 50mg mitomycin bound to a solution of 375mg carbon adsorbent intraperitoneally before or after closure of the abdominal wound n＝34 or served as a control group n＝34． Postoperatively the patients with MMC－CH and in control group received systemic chemotherapy 3 months and 3 weeks respectively． The postoperative recurrence－free and overall survival time were evaluated to analyse the benefits of this treatment． Results The animal experiment gained a satisfactory result the small cancer foci were detected in the peritoneal cavity in only 2 of 8 mice in MMC－CH group the relative peritoneal carcinomatosis was found in 3 of 8 mice in MMC group the peritoneal carcinomatosis was under control only in 2 of 8 mice in MMC－Ⅳ group the extensive intraperitoneal carcinomatosis was found in all of 8 mice in control group． After a median observation period of 15．4 months ranged 2~36 a significantly higher postoperative recurrence－free time of 2~3 year was observed in the MMC－CH group 76．27％ 76．27％ as compared with the control group 34．24％ 22．83％ P＜ 0．05． Conclusion Adjuvant intraperitoneal chemotherapy of gastric cancer by mitomycin bound to activated carbon particles is effective and with an increased postoperative recurrence－free survival time．