腹腔热灌注化疗联合静脉化疗治疗晚期胃肠道肿瘤的疗效

Clinical efficacy of continuous hyperthermic peritoneal perfusion combined with etoposide by vein in patients with advanced gastric cancer

目的探讨腹腔热灌注化疗联合静脉化疗对晚期胃肠道肿瘤患者的治疗效果。方法选择70例晚期胃肠道肿瘤患者,按照临床试验数字随机法分为治疗组和对照组,每组35例。对照组患者予以静脉化疗进行治疗,治疗组患者在对照组的基础上加用腹腔热灌注化疗进行治疗,比较两组患者的治疗效果、生存时间、不良反应以及免疫功能变化。结果治疗组患者的治疗有效率为68.6%,显著优于对照组的40.0%(P<0.05)。治疗组患者生存期显著高于对照组(P<0.05)。治疗组患者不良反应发生率低于对照组,但差异无统计学意义(P>0.05)。治疗组患者术后CD3+T细胞、CD4+T细胞水平升高,CD8+T细胞水平降低(P<0.05)。对照组患者CD3+T细胞、CD4+T细胞、CD8+T细胞水平变化不大(P>0.05)。结论与单纯静脉化疗相比,腹腔热灌注联合静脉化疗能有效治疗晚期胃肠道肿瘤患者,治疗有效率高,患者生存率高,不良反应率低。

Objective To investigate the clinical efficacy of continuous hyperthermic peritoneal perfusion（ CHPP） combined with etoposide by vein in treatment of patients with advanced gastric cancer.Methods A total of 70 cases were randomized into control group and observation group,and each group had35 cases. Patients in control group were treated by etoposide,while patients in observation group were treated by CHPP and etoposide. The clinical efficacy,survival,adverse reactions rate and immune function changes of two groups were compared. Results The effectiveness rate of observation group was 68. 6%（ 24 /35）,which was significantly higher than that of control group [40. 0%（ 14 /35） ]（ P〈0. 05）. Survival of observation group was significantly higher than that of control group（ P〈0. 05）. Adverse reactions rate of observation group was higher than that of control group,but the difference was no significant（ P〉0. 05）. After treatment,CD3＋T and CD4＋T level of observation group were significantly improved,and CD8＋T level was significantly reduced（ P〈0. 05）. The CD3＋T,CD4＋T,CD8＋T level of control group changed little. Conclusions Compared with etoposide,CHPP combined with etoposideby vein can effective treat patients with advanced gastric cancer. The efficacy is higher,survival rate after treatment is higher,and the adverse reactions rate is lower.