中晚期胃癌行介入灌注化疗栓塞术的疗效评估

Evaluation of therapeutic effect of interventional perfusion chemoembolization in treating advanced gastric cancers

目的探讨并评估介入灌注化疗栓塞术治疗中晚期胃癌的价值和临床疗效。方法回顾性分析我科2010年1月—2013年1月接受介入灌注化疗栓塞治疗的中晚期胃癌患者44例,术后随访6个月至2年。对术前及术后临床症状的改善,肿瘤病灶的大小等资料进行分析比较。结果介入治疗后上腹饱胀、疼痛临床症状缓解的患者有37例(37/44,84.1%),恶心、呕吐临床症状缓解的患者有24例(24/28,85.7%),10例粪便潜血试验阳性者7例转阴,8例存在腹水的患者未缓解;10例介入治疗肿瘤降期后接受外科手术切除治疗。进行6、12和24个月的随访,患者的生存率分别为81.8%(36/44)、59.1%(26/44)、18.2%(8/44)。结论介入灌注化疗栓塞术治疗是安全、有效的,能改善患者的临床症状并降低其肿瘤分期,治疗中晚期胃癌近期及中期疗效较满意,远期疗效的评估有待进一步随访。

Objective To evaluate the clinical efficacy of interventional intra- arterial chemoembolization in treating advanced gastric cancers, and to discuss its clinical application. Methods During the period form January 2010 to January 2013 at authors＇ department, a total of 44 patients with advanced gastric cancer received interventional intra- arterial chemoembolization. The clinical data were retrospectively analyzed. After the treatment all the patients were regularly followed up for 6 months to 2years. Before and after the treatment the clinical symptoms and tumor size were determined, and the results were analyzed. Results After the treatment, the clinical symptoms such as the sensation of fullness and pain at epigastric area was remarkably relived in 37 patients（37/44, 84.1%）, and nausea as well as vomiting was improved in 24 patients（24/28, 85.7%）, positive occult blood in stool turned to negative in 7 patients（7/10,70%） and pre- existing ascites in 8 patients showed no improvement（8/8）. Surgery was performed in 10 patients after interventional treatment as their tumor became degradation after interventional treatment. The survival rates at 6, 12 and 24 months after the treatment were 81.82%（36/44）, 59.09%（26/44） and 18.18%（8/44） respectively. Conclusion For the treatment of advanced gastric cancers, the interventional perfusion chemoembolization therapy is safe and effective. This technique can effectively improve patient＇s clinical condition and lower the tumor staging with satisfactory short- term and mid- term efficacy, although its long-term efficacy needs to be further studied.