术前动脉灌注化疗加栓塞介入治疗原发性胃癌的疗效及安全性评价

Efficacy and safety of preoperative arterial perfusion chemotherapy plus embolization in the treatment of patients with primary gastric cancer

目的评价术前动脉灌注化疗加栓塞介入治疗原发性胃癌患者的疗效及安全性。方法回顾性选取2018年12月至2020年12月期间于榆林市第一医院行胃癌根治术的96例原发性胃癌患者为研究对象,依据术前是否介入治疗分为非介入组(n=46)和介入组(n=50)。非介入组患者直接进行手术治疗,介入组患者在术前行动脉灌注化疗加栓塞介入治疗,比较两组患者腹腔脱落癌细胞阳性率、手术切除率、1年内生存率、复发率和转移率,观察介入组患者的不良反应情况,并比较两组患者术后并发症、围术期指标及术后恢复情况。结果介入组患者开腹后脱落癌细胞的阳性率为8.00%,明显低于非介入组的26.09%,差异有统计学意义(P<0.05);介入组患者的手术切除率和根治性切除率分别为90.00%,88.00%,明显高于非介入组的73.91%和65.22%,差异均有统计学意义(P<0.05);介入组患者1年生存率为54.00%,略高于非介入组的43.48%,但差异无统计学意义(P>0.05);介入组患者的复发率和转移率分别为14.00%、12.00%,明显低于非介入组的35.29%、30.43%,差异均有统计学意义(P<0.05);介入组患者治疗后的不良反应均较轻,多为Ⅰ~Ⅱ级,经相应处理后均缓解;介入组患者术后并发症为24.00%,略高于非介入组的13.04%,但差异无统计学意义(P>0.05);两组患者术中出血量、术后恢复情况比较差异无统计学意义(P>0.05)。结论术前行动脉灌注化疗加栓塞介入治疗能提高原发性胃癌患者的手术切除率,减少胃癌腹腔内癌细胞的脱落,改善患者的短期预后,具有较高的安全性。

Objective To evaluate the efficacy and safety of preoperative arterial perfusion chemotherapy plus embolization in the treatment of patients with primary gastric cancer.Methods Ninety-six patients with primary gastric cancer who underwent radical gastrectomy in the First Hospital of Yulin from December 2018 to December 2020 were retrospectively selected as the study subjects.The patients were divided into non-interventional group(n=46)and interventional group(n=50)according to whether they received preoperative interventional therapy.Patients in the non-interventional group received direct surgical treatment,while patients in the intervention group received arterial perfusion chemotherapy plus embolization before operation.The positive rate of peritoned exfoliated cancer cells,surgical resection rate,1-year survival rate,recurrence rate,and metastasis rate were compared between the two groups.The adverse reactions were observed in the intervention group,and postoperative complications,perioperative indexes,and postoperative recovery were compared between the two groups.Results The positive rate of exfoliated cancer cells in the interventional group was 8.00%,which was significantly lower than 26.09% in the non-interventional group(P<0.05).The surgical resection rate and radical resection rate of patients in the interventional group were 90.00% and 88.00%,respectively,which were significantly higher than 73.91% and 65.22% in the non-interventional group(P<0.05).The 1-year survival rate of the interventional group was 54.00%,which was slightly higher than 43.48% of the non-interventional group,with no statistically significant differences(P>0.05).The recurrence rate and metastasis rate in the interventional group were 14.00% and 12.00%,respectively,which significantly lower than 35.29% and 30.43% in the non-interventional group(P<0.05).The adverse reactions of the interventional group were mild,mostly grade Ⅰ~Ⅱ,and were relieved after corresponding treatment.The postoperative complications in the interventional group were 24.00%,which were slightly higher than 13.04% in the non-interventional group(P>0.05).There were no significant differences in intraoperative blood loss and postoperative recovery between the two groups(P>0.05).Conclusion Preoperative arterial perfusion chemotherapy plus embolization in the treatment of patients with primary gastric cancer can improve the surgical resection rate,reduce the peritoneal exfoliated cancer cells,improve the short-term prognosis of patients,with high safety.