选择性动脉插管灌注化疗栓塞治疗中晚期胃癌的疗效观察

Observasion on the therapeutic effects of selective infusion chemotherapy and chemoembolization by artery intubation in treatment of advanced gastric cancer

目的 评价选择性动脉插管灌注化疗栓塞对中晚期胃癌的临床疗效及价值。方法 对 49例不能手术或手术后复发转移的中晚期胃癌患者行胃动脉内灌注化疗和栓塞化疗合计 1 2 7次。化疗方案FAM(5 氟脲嘧啶、丝裂霉素、阿霉素或表阿霉素 )或FPM(5 氟脲嘧啶、丝裂霉素、顺铂或卡铂 ) ,栓塞剂选用超液化碘油或超液化碘油加明胶海绵。近期疗效以上消化道造影、CT、B超、胃镜检查结果作为评价标准。结果 肿瘤原发灶有效率 54 .5 % ,局部淋巴结有效率 46 .4 % ,远处转移有效率 32 .1 %。本组 1、3、5年生存率分别为 51 .1 % ,1 3 .3 % ,4.4 %。全组未发生严重副作用及并发症。结论 选择性动脉插管灌注化疗栓塞对于中晚期胃癌是一种有效的治疗方法 。

Objective To evaluate the efficacy of selective arterial infusion chemotherapy and chemoembolization in treatment of advanced gastric cancer.Methods A total of 49 patients with advanced gastric cancer that was unresectable or local recurrent and metastatic after operation were treated 127 times by gastric arterial infusion chemotherapy and chemoembolization.Chemotherapy was carried out with FAM regimen or FPM regimen.FAM regimen consisted of 5 fluorouracil,mitomycin and adriamycin or epirubicin,FPM regimen consisted of 5 fluorouracil mitomycin and cisplatin or carboplatin.Embolization was accomplished with lipiodol ultra fluid or lipiodol ultra fluid and gelutin sponge.Response rate was assessed by photograph of upper digestive tract,computed tomography,ultrasonic,fibergastroscope.Results The response rate of primary locus was 54.5%(CR+PR).The response rate of lymph node metastasis was 46.4%(CR+PR) and distant metastasis was 32.1%(CR+PR).The 1 ,3 ,5 year survival rate was 51.1%?13.3%?4.4% respectively.There was no severe side effect or complication.Conclusion The selective arterial infusion chemotherapy and chemoembolization is an effective method in the treatment of advanced gastric cancer and worthy to be further studied.