区域动脉灌注化疗联合明胶海绵颗粒栓塞治疗不可切除胃底贲门癌的有效性及安全性

Efficacy and safety of regional arterial infusion chemotherapy combined with gelatin sponge particle embolization in the treatment of unresectable stomach fundus and cardia cancer

目的 探讨区域动脉灌注化疗联合明胶海绵颗粒栓塞对不可切除胃底贲门癌的治疗效果。方法 根据治疗方式的不同将120例不可切除胃底贲门癌患者分为对照组和观察组,每组60例,对照组患者采用区域动脉灌注化疗,观察组患者采用区域动脉灌注化疗联合明胶海绵颗粒栓塞治疗。比较两组患者的治疗效果、胃肠激素[胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ)和胃泌素(GAS)]水平、血管内皮生长因子(VEGF)水平、缺氧诱导因子-1α(HIF-1α)水平、不良反应发生率及6个月生存率。结果 观察组患者的总有效率为91.67%,高于对照组患者的78.33%,差异有统计学意义(P﹤0.05)。治疗后1个月,两组患者的PGⅠ、PGⅡ和GAS水平均高于本组治疗前,且观察组患者的PGⅠ、PGⅡ和GAS水平均高于对照组,差异均有统计学意义(P﹤0.05)。治疗后1个月,两组患者的VEGF、HIF-1α水平均低于本组治疗前,且观察组患者的VEGF、HIF-1α水平均低于对照组,差异均有统计学意义(P﹤0.05)。两组患者的不良反应总发生率比较,差异无统计学意义(P﹥0.05)。观察组患者的6个月生存率为91.67%(55/60),高于对照组患者的75.00%(45/60),差异有统计学意义(P﹤0.05)。结论 区域动脉灌注化疗联合明胶海绵颗粒栓塞对不可切除胃底贲门癌的治疗效果较好,可改善患者的胃肠功能,降低VEGF、HIF-1α水平,提高近期生存率,且未增加不良反应,具有较好的应用价值。

Objective To observe the therapeutic effect of regional arterial infusion chemotherapy combined with gelatin sponge particle embolization in the treatment of unresectable stomach fundus and cardia cancer. Method A total of120 patients with unresectable stomach fundus and cardia cancer were divided into control group and observation group according to different treatment methods with 60 cases in each group. The patients in the control group were treated with regional arterial infusion chemotherapy, and the patients in the observation group were treated with regional arterial infusion chemotherapy combined with gelatin sponge particle embolization. The therapeutic effects, gastrointestinal hormones [pepsinogen I(PGI), pepsinogen II(PGII), and gastrin(GAS)] levels, vascular endothelial growth factor(VEGF)level, hypoxia-inducible factor-1α(HIF-1α) level, the incidence of adverse events, and 6-month overall survival were compared between the two groups. Result The total response rate of patients in the observation group was 91.67%,which was higher than that of 78.33% in the control group, and the difference was statistically significant(P<0.05). One month after the treatment, the levels of PGI, PGII, and GAS in the two groups were higher than those before the treatment, and the levels of PGI, PGII, and GAS in the observation group were higher than those in the control group, the differences were statistically significant(P<0.05). One month after the treatment, the levels of VEGF and HIF-1α in the two groups were lower than those before the treatment, and the levels of VEGF and HIF-1α in the observation group were lower than those in the control group, the differences were statistically significant(P<0.05). There was no significant difference in the total incidence of adverse events between the two groups(P>0.05). The 6-month overall survival rate of the observation group was 91.67%(55/60), which was higher than that of 75.00%(45/60) of the control group, the difference was statistically significant(P<0.05). Conclusion Regional arterial infusion chemotherapy combined with gelatin sponge particle embolization could achieve a good effect on the treatment of unresectable stomach fundus and cardia cancer. The intervention is of promising application value and could improve the patient’s gastrointestinal function, decrease the levels of VEGF and HIF-1α, and increase short-term survival without increasing the risk of adverse events.