经动脉灌注化疗联合不同化疗方法治疗进展期胃癌60例对照研究

Combination of chemotherapy and interventional management for the treatment of advanced gastric cancer:comparison study of different chemotherapy routes

目的 探讨不同化疗途径联合介入治疗进展期胃癌的安全性和疗效。方法 经胃镜检查及活组织病理学检查确诊的胃腺癌患者60例，随机分为A组和B组，每组30例。介入术中采用EOF方案（5-蛳 Fu 500 mg/m2，奥沙利铂130 mg/m2，表柔比星40 - 60 mg），A组在介入术后d 1 ～ 4经静脉使用CF（亚叶酸钙）150 mg/m2维持2 h，30 min后使用5？蛳 Fu 500 mg/m2 维持6 h，4周为1周期，B组术后口服替吉奥，40 ～ 60 mg，2次/d，d 8 ～ 21，休息1周，再进行下一周期的治疗。比较两组治疗后不良反应及生存率。结果 所有患者均完成至少2周期治疗。两组白细胞、血小板减少和恶心呕吐等不良反应比较差异有统计学意义（P 〈 0.05），两组K？蛳 M生存曲线比较差异无统计学意义（P = 0.625）。结论 替吉奥口服化疗较之5？蛳 Fu全身静脉化疗联合介入治疗进展期胃癌安全性更高，从而提高了患者的生活质量。

Objective To explore the safety and efficacy of chemotherapy through different routes combined with interventional management in treating advanced gastric cancer. Methods A total of 60 patients with gastroscopy-and biopsy-proved gastric adenocarcinoma were enrolled in this study, The patients were randomly and equally divided into group A （n = 30） and group B （n = 30）. EOF scheme of chemotherapy, i.e. 5-Fu 500 mg/m2, epirubicin 40 - 60 mg and oxaliplatin 130 mg/m2, was employed in all patients for interventiona] management. Then patients in group A received intravenous chemotherapy （CF 150 mg/m2 lasting for 2 hours and 30 minutes later 5- Fu 500 mg/m2 lasting for 6 hours）, which was can＇ied out during the 1st to the 4th （lay after the intervention, and every four weeks constituted a single therapeutic course. Patients in group B received oral chemotherapy （tegafur 40 - 60 mg two times per day） during the 8th to the 21st day alter the intervention. After one week the next course of oral chemotherapy was repeated. The adverse effects and Kaplan-Merier survival curves were eompared between the two groups. Results At least two courses of treatment were accomplished in each patient. Significant differences in alcukocytosis, thrombocytopenia, nausea and vomiting existed between the two groups （P 〈 0.05）, while no significant dift〉rencc in Kaplan- Merier survival curves existed between the two groups （P = 0.625）. Conclusion Oral administration of tegafur is superior to systemic intravenous chenmtherapy with 5- Fu in treating advanced gastric cancer when intctwentional therapy is employed together. The oral administration of tegafur is safer, and the patient＇s life quality can be markedly improvcd.