局部晚期胃癌术后腹腔热灌注联合放化疗的疗效研究

Therapeutic effect of intraperitoneal hyperthermic perfusion combined with radiotherapy and chemotherapy in patients with locally advanced gastric cancer after surgery

目的探讨局部晚期胃癌术后腹腔热灌注联合放化疗的治疗效果。方法选择2013年6月～2015年6月在我院普外三科收治的行手术治疗的60例局部晚期胃癌患者,随机分为实验组25例,行腹腔热灌注化疗联合术后放化疗,对照组35例,仅行术后放化疗,比较两组的临床疗效。结果两组术后肠瘘、肠梗阻发生率比较差异均无统计学意义(P>0.05),实验组术后腹胀、发热发生率均高于对照组,差异均有统计学意义(P<0.05);两组患者治疗前CEA、CA72-4差异无统计学意义(P>0.05),同组患者治疗后CEA、CA72-4水平明显低于治疗前,差异均有统计学意义(P<0.05),实验组治疗后CEA、CA72-4水平低于对照组,其中CA72-4差异有统计学意义(P<0.05);实验组术后局部复发率、病死率低于对照组,差异有统计学意义(P<0.05)。结论腹腔热灌注化疗联合术后放化疗治疗局部晚期胃癌,可以提高临床疗效,降低肿瘤复发率和病死率,有助于延长术后生存时间,改善患者的生活质量。

Objective To investigate the therapeutic effect of intraperitoneal hyperthermic perfusion combined with radiotherapy and chemotherapy in patients with locally advanced gastric cancer.Methods 60 patients with locally advanced gastric cancer who underwent surgical treatment from June 2013 to June 2015 in the Third Department of General Surgery of our hospital,were randomly divided into the experimental group and the control group.25 patients in the experimental group underwent peritoneal hyperthermic perfusion chemotherapy combined with postoperative radiotherapy and chemotherapy.35 patients in the control group underwent only postoperative radiotherapy and chemotherapy.The clinical effects of the two groups were compared.Results There was no significant difference in the incidence of postoperative intestinal fistula and intestinal obstruction between the two groups(P>0.05).The incidence of postoperative abdominal distension and fever in the experimental group was higher than that in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in CEA and CA72-4 between the two groups before treatment(P>0.05).The levels of CEA and CA72-4 in the same group were significantly lower than those before treatment,and the difference was statistically significant(P<0.05).The levels of CEA and CA72-4 in the experimental group after treatment were lower than those in the control group,and the difference of CA72-4 was statistically significant(P<0.05).The local recurrence rate and mortality rate of the experimental group were lower than those of the control group,with significant difference(P<0.05).Conclusion Intraperitoneal hyperthermic perfusion chemotherapy combined with postoperative radiotherapy and chemotherapy for locally advanced gastric cancer can improve clinical efficacy,reduce tumor recurrence rate and mortality,and help to prolong postoperative survival time and improve patients'quality of life.