替吉奥联合高频热疗及灌注化疗治疗晚期胃癌合并腹腔积液效果观察

Effect observation on S-1 joint high-frequency diathermic therapy and perfusion chemotherapy in the treatment of advanced gastric cancer complicated with seroperitoneum

目的探讨口服替吉奥联合高频热疗、灌注化疗治疗晚期胃癌合并腹腔积液的临床疗效及患者不良反应。方法52例晚期胃癌患者分为观察组和对照组。观察组25例给予顺铂60mg／m^2＋5．氟尿嘧啶600mg／m^2＋白细胞介素2300万U腹腔灌注化疗；替吉奥40mg口服，2次／d，第1天至第14天；21d为1个周期，连续应用2—3个周期；腹腔灌注化疗后30min进行高频热疗，2次／周×3周。对照组27例腹腔灌注化疗及替吉奥用法、用量同观察组，未进行高频热疗。结果观察组25例中完全缓解（CR）4例，部分缓解（PR）15例，稳定（SD）5例，进展（PD）1例，有效（CR＋PR）率为76％；对照组27例中CR3例，PR14例，SD7例，PD3例，有效率为63％。两组有效率差异无统计学意义（P〉0．05）。观察组中位生存时间为10．0个月，对照组为8．0个月，两组差异无统计学意义（P〉0．05）。观察组治疗后Karnofsky评分高于对照组，患者生命质量临床受益（生命质量显著改善＋改善）率为80．0％（20／25），高于对照组的51．9％（14／27），两组差异有统计学意义（χ^2=4．544，P=0．033）。两组不良反应发生情况差异无统计学意义（P〉0．05）。结论口服替吉奥联合高频热疗、灌注化疗治疗晚期胃癌合并腹腔积液有较好的近期疗效和安全眭，是值得进一步探讨的治疗方法。

Objective therapy combined with oral S-1 advanced gastric carcinoma. To explore the therapeutic effect and safety of high-frequency diathermic and intraperitoneal perfusion chemotherapy on malignant seroperitoneum of Methods Fifty-two advanced gastric carcinoma patients with malignant seroperitoneum were divided into observation group and control group. Twenty-five patients in observation group were received DDP 60 mg/m^2 combined with 5-Fu 600 mg/m^2 and IL-2 3 000 000 U intraperitoneal perfusion chemotherapy,as well as oral S-1 of 40mg bid on day 1-14 of every 21 days for a total of two or three cycles. High-frequency diathermic therapy was administered thirty minutes after intraperitoneal perfusion chemotherapy,twice a week for 3 weeks. Twenty-seven patients in control group were treated with S-1 and intraperitoneal perfusion chemotherapy only. Results In observation group, 4 patients were CR, 15 patients were PR, 5 patients were SD, 1 patient was PD, and the response rate （CR＋PR） was 76 %. In control group, 3 patients were CR, 14 patients were PR, 7 patients were SD, 3 patients were PD, and the response rate （CR＋ PR） was 63 % （P 〉 0.05）. Median survial time for observation group was 10.0 months, 8.0 months for control group （P 〉 0.05）. Karnofsky scores after treatment in observation group was higher than that in control group, patients＂ clinical benefit rate were 80.0 % （20/25） and 51.9 % （14/27）. The difference in life quality between the two groups was statistically significant （P 〈 0.05）. There was no significant difference in adverse reactions between the two groups （χ^2 = 4.544, P = 0.033）. Conclusion High-frequency diathermic therapy combined with oral S-I and intraperitoneal perfusion chemotherapy for advanced gastric carcinoma with malignant seroperitoneum has good short-term curative effects and security, and this method should be further studied.