紫杉醇腹腔灌注和静脉滴注双途径给药模式二线治疗胃癌伴恶性腹腔积液的效果

Effects of second-line intraperitoneal and intravenous chemotherapy with paclitaxel on gastric cancer complicated with malignant ascites

目的分析紫杉醇腹腔灌注和静脉滴注双途径给药模式二线治疗胃癌伴恶性腹腔积液的效果。方法选择2014年1月至2015年12月江苏省苏州市立医院北区肿瘤科收治的晚期胃癌伴恶性腹腔积液患者70例。患者完全随机分为观察组(36例)和对照组(34例)。对照组给予静脉滴注紫杉醇;观察组采用腹腔灌注和静脉滴注紫杉醇的双途径给药模式;2组均联合口服替吉奥80 mg/m^2,2次/d,连服14 d,化疗后休息7 d,21 d为1个疗程。2组至少治疗2个疗程。比较2组患者近期疗效、长期疗效和不良反应情况。结果观察组患者近期有效率明显高于对照组[69.4%(25/36)比44.1%(15/34)],差异有统计学意义(χ~2=4.58,P<0.05)。观察组中位随访时间、中位无进展生存期、中位生存时间和1年生存率与对照组比较,差异均无统计学意义(均P>0.05)。观察组白细胞减少、血小板减少、贫血、恶心呕吐、口腔黏膜炎、肝功能异常、腹痛腹泻、肌肉关节痛发生率与对照组比较,差异均无统计学意义(均P>0.05)。结论紫杉醇腹腔灌注和静脉滴注双途径给药模式治疗胃癌伴恶性腹腔积液的近期疗效较好,不良反应轻,可耐受。

Objective To investigate effects of second-line intraperitoneal and intravenous chemotherapy with paclitaxel on gastric cancer complicated with malignant ascites. Methods Totally 70 gastric cancer patients with malignant ascites from January 2014 to December 2015 in Suzhou Municipal Hospital were randomly divided into observation group（36 cases） and control group （34 cases）. Tile control group had intravenous chemotherapy with paclitaxel; the observation group had intraperitoneal and intravenous chemotherapy with paclitaxel. Both groups took tegafur 80 mg/m2, 2 times/d, 1-14 d, 21 d for 1 course, and they were treated for 2 courses. Short-, long-term efficacy and adverse reactions were analyzed. Results The short-teml effective rate in observation group was significantly higher than that in control group[69.4% （25/36） vs 44. 1% （15/34） ） ] （x^2 =4. 58 ,P 〈0. 05）. Median follow-up time, median progression free survival time, median survival time and 1-year survival rate in observation group had no significant differences compared to those in control group （ P 〉 0. 05 ）. There were no significant differences of incidences of leukocytopenia, thrombocytopenia, hypohemia, nausea and vomiting, oral mucositis, liver dysfunction, abdominal pain and diarrhea, muscle and joint pain between groups （P 〉 0. 05 ）. Conclusion Intravenous and intraperitoneal chemotherapy with paclitaxel have good short-term efficacy and tolerable side effects on patients with gastric cancer complicated with malignant ascites.