中晚期胃癌介入化疗的临床研究

Clinical study of interventional chemotherapy for middle-late gastric carcinoma

目的 观察中晚期胃癌患者行动脉介入化疗的临床疗效,并探讨其作用机制.方法 将110例中晚期胃癌患者随随机分为动脉介入化疗组和全身静脉化疗组.动脉介入化疗组60例,行胃左动脉、胃右动脉、胃十二指肠动脉和胃网膜右动脉1支或多支动脉灌注化疗药物亚叶酸钙、氟尿嘧啶和奥沙利铂;全身静脉化疗组50例,应用亚叶酸钙、氟尿嘧啶和奥沙利铂全身静脉化疗.结果 动脉介入化疗组3例完全缓解（CR）,46例部分缓解（PR）,总有效率为81.67％.全身静脉化疗组1例CR、26例PR,总有效率为54.00％,同时2组累计生存率比较差异有统计学意义（P＜0.05）,同时动脉介入化疗组生活质量较全身静脉化疗组有提高.结论 在中晚期胃癌治疗中,动脉介入化疗疗效要优于全身静脉化疗,能延长患者的生存期.

Objective To observe the clinical curative effect of arterial interventional chemotherapy （AICP） for middle-late gastric cancer,and to explore its action mechanism.Methods 110 patients with middle-late gastric cancer were randomly divided into AICP group and systemic vein chemotherapy （SVC） group.In AICP group （n =60）,via left gastric artery,right gastric artery,gastroduodenal artery and one or multiple branches of right gastroepiploic artery,leucovorin,fluorouracil and oxaliplatin were arterially perfused.In SVC group （n =50）,leucovorin,fluorouracil and oxaliplatin were intravenously given.Results Three cases obtained complete response （CR）,46 cases partial response （PR）,and the total effective rate was 81.67% in AICP group.One case obtained CR,26 cases PR,and the total effective rate was 54.00% in SVC group.There was significant diference in the cumulative survival rate between the two groups.The quality of life in AICP group was significantly improved as compared with SVC group.Conclusion In the treatment of middle-late gastric cancer,the curative effect of AICP is superior to SVC,and can prolong the survival of patients with gastric carcinoma.