腹腔热灌注化疗对进展期胃癌疗效的临床研究

Clinical study on efficacy of hyperthermic intraperitoneal chemotherapy in treatment of advanced gastric cancer

目的研究腹腔热灌注化疗治疗进展期胃癌的临床效果。方法回顾性分析2016年9月至2020年9月在锦州医科大学附属第一医院接受手术治疗的进展期胃癌患者80例。根据治疗方式的不同分为试验组和对照组,其中试验组接受腹腔镜下D2根治术+腹腔热灌注化疗+全身静脉化疗共50例,对照组接受腹腔镜下D2根治术+全身静脉化疗共30例。比较两组的治疗效果及不良反应发生情况。结果治疗后,试验组患者的CD3+、CD4+和CD4+/CD8+水平高于对照组及治疗前(P<0.05),CD8+水平低于对照组及治疗前(P<0.05)。试验组的总有效率为90.00%,明显高于对照组的73.33%,差异有统计学意义(P<0.05)。术后3年试验组的功能评分、整体生活质量评分、单项测量项目评分均高于对照组(P<0.05),症状评分低于对照组(P<0.05)。两组患者术后不良反应及并发症总发生率比较,差异无统计学意义(P>0.05)。试验组3年无进展生存率高于对照组(P<0.05),局部复发和远处转移率低于对照组(P<0.05)。结论腹腔热灌注化疗治疗进展期胃癌较为安全有效。

Objective To study the clinical efficacy of hyperthermic intraperitoneal chemotherapy in the treatment of advanced gastric cancer.Methods A retrospective analysis of 80 patients with advanced gastric cancer underwent surgery in our hospital from September 2016 to September 2020 was conducted.According to the different treatment methods,they were divided into the experimental group with 50 patients received laparoscopic radical D2+intraperitoneal hyperthermic chemotherapy+systemic intravenous chemotherapy,and the control group with 30 patients received laparoscopic radical D2+systemic intravenous chemotherapy.The efficacy and occurrence of adverse events were compared between the two groups.Results After treatment,the levels of CD3+,CD4+and CD4+/CD8+in the experimental group were higher than those in the control group and before treatment(P<0.05),The level of CD8+in the experimental group was lower than that in the control group and before treatment(P<0.05).The total effective rate in the experimental group was 90.00%,which was higher than that of 73.33%in the control group,with significant difference(P<0.05).Three years after operation,the scores of function,overall quality of life,individual measurement item in the experimental group were higher than those in the control group(P<0.05),the symptom score was lower than that in the control group(P<0.05).There was no significant difference of incidence of postoperative adverse reactions and complications?between the two groups(P>0.05).Three year progression-free survival rate in the experimental group was higher than that in the control group(P<0.05),the rates of local recurrence and distant metastasis were lower than that in the control group(P<0.05).Conclusion The intraperitoneal hyperthermic chemotherapy is safe and effective in the treatment of advanced gastric cancer.