胃癌术后腹腔内化疗的作用

Intraperitoneal chemotherpy for the prevention of postoperative peritoneal recurrence in patient with gastric carcinoma

目的 侵及浆膜的胃癌腹膜种植复发是外科治疗失败的重要因素之一。本文探讨术后腹腔内化疗在防治腹膜复发的作用。方法 对天津医科大学附属肿瘤医院 3年间行手术治疗的胃癌 40 4例中癌肿侵及浆膜但无种植灶及远处转移的 81例随机分为 2组 ,一组行术中、术后腹腔内和静脉化疗 (IC +Ⅳ ) ,另一组单纯静脉化疗 (IV) ,对其临床效果进行对照观察。结果 IC +Ⅳ组 1,3 ,5年存活率为 89% ,73 % ,5 7% ,对照组为 83 % ,61%和 3 9% ,5年存活率P =0 .0 416。结论 腹腔内化疗因其腹腔内药物浓度高 ,剂量大 ,毒副作用小 ,对侵及浆膜的胃癌有着积极防止复发的作用。

Objective A majority of gastric carcinoma patients with serosal invasion died of peritoneal recurrence,even when a curative gastrectomy has been performed.In an attempt to prevent peritoneal recurrence,intraperitoneal chemotherapy(IC) has been applied.Methods Between January,1991 and January,1994,404 gastric carcinoma patients were treated in Tianjin Cancer Center.81 of them with macroscopic serosal invasion were allocated randomly into 2 groups,41 cases udnerwent IC,and 40 did not.All of them received intravenous chemotherapy.Results The 1,3,5 year survival rate for the IC+Ⅳ group was 98%,73%,57% respectively,whereas that for control group were 85%,61%,and 39%.Conclusions Intraperitoneal chemotherpy(IC) shows more favorable advantages, preventing peritoneal recurrence in gastric carcinoma with serosal invasion. [