肿瘤深部热化疗对复发转移胃癌生存期的影响及其预测因素

Influence of deep hyperthermia combined with systemic chemotherapy on overall survival of recurrent gastric cancer patients:Predictors of response to treatment

目的:肿瘤深部热疗联合全身化疗对复发转移胃癌总生存期的影响,探讨个体化治疗预测因素.方法:分析99例复发转移胃癌患者,其中热化疗组42例,进行肿瘤深部热疗+全身化疗;单纯化疗组57例,单纯接受全身化疗,作为对照.统计两组患者的生存期,并将其统计结果使用SPSS16.0统计软件进行统计学分析.结果:热化疗组中位生存期(18 mo)显著长于单纯化疗组生存期(12.8 mo)(P=0.003);热化疗组中白蛋白(albumin,ALB)≥35 g/L患者的生存期(19 mo)显著长于ALB<35 g/L患者的生存期(10 mo)(P=0.027);热化疗组中,中性粒细胞/淋巴细胞比值(neutrophil/lymphocyte ratio,NLR)<4.558患者的生存期(33 mo)显著长于NLR≥4.558患者的生存期(10 mo)(P=0.007).结论:深部热化疗治疗复发转移胃癌患者可提高患者的生存期,正常血清ALB和NLR低值可进一步个体化预测其生存获益;而低血清ALB及高NLR值有损生存期,不建议这类患者做肿瘤深部热化疗.

AIM： To investigate the effect of tumor deep hyperthermia combined with systemic chemotherapy on overall survival（OS） of recurrent gastric cancer patients, and to explore the predictors of response to the treatment. METHODS： Ninety-nine patients with recurrent gastric cancer were divided into either a thermochemotherapy group（n = 42） or a control group（n = 57）. The thermo-chemotherapy group was treated by deep tumor hyperthermia and chemotherapy, and the control group received systemic chemotherapy alone. The OS was compared for the two groups, and the predictors of response to individualized treatment was analyzed.RESULTS： The median OS was significantly longer in the thermo-chemotherapy group than in the control group（18 mo vs 12.8 mo. P = 0.003）. In the thermo-chemotherapy group, the OS of patients with albumin（ALB） ≥ 35 g/L（19 mo） was better than that of patients with ALB 35g/L（10 mo）（P = 0.027）; and the OS of patients with a neutrophil/lymphocyte ratio（NLR） 4.558（33 mo） was superior than that of patients with an NLR ≥ 4.558（10 mo）（P = 0.007）. CONCLUSION： For recurrent gastric cancer patients, thermotherapy combined with chemotherapy may be a more effective treatment option. Patients with normal serum ALB and an NLR 4.558 may have a better prognosis. For patients with ALB 35 g/L and an NLR ≥4.558, deep tumor hyperthermia combined with systemic chemotherapy is not recommended.