术中腹腔灌注雷替曲塞联合术后化疗治疗老年进展期胃癌疗效及安全性研究

Safety and Therapeutic Effects Analysis of Raltitrexed for Intraperitoneal Chemotherapy in the Elderly with Advanced Gastric Cancer

目的 探讨术中腹腔灌注雷替曲塞治疗老年进展期胃癌的疗效及安全性。方法 选择老年进展期胃癌90例,随机分为对照组和观察组各45例,观察组患者术中腹腔灌注化疗药物雷替曲塞,术后予以奥沙利铂联合口服替吉奥化疗治疗,对照组患者仅术后予以奥沙利铂联合口服替吉奥化疗治疗。比较两组术后化疗相关不良反应、手术并发症及术后远期复发情况、生存率等。结果 观察组与对照组患者术后肠功能恢复时间分别为(5.33±0.95)d与(5.15±0.97)d,两组比较差异无统计学意义(P>0.05);两组术后并发症、化疗不良反应发生率差异无统计学意义(P>0.05);两组患者化疗后白细胞(WBC)、中性粒细胞数(NE)、血小板(PLT)、天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)、血红蛋白(Hb)、肌酐(Cr)等指标差异均无统计学意义(P均>0.05);观察组与对照组患者术后12、36、60个月复发比例分别为4.44%、13.33%、40.0%与15.56%、31.11%、71.11%,观察组术后36、60个月复发率低于对照组(P<0.05);观察组患者5年总生存率高于对照组(P<0.05)。结论 腹腔灌注雷替曲塞联合术后奥沙利铂联合口服替吉奥化疗应用于老年进展期胃癌患者具有较好的安全性,且在远期预后方面具有一定疗效。

Objective To explore the safety and therapeutic effects of raltitrexed for intraperitoneal chemotherapy in the elderly with advanced gastric cancer.Methods Ninety elderly with advanced gastric cancer were selected and randomly divided into 2 groups:observation group and control group,with forty-five in each group.The treatment,which combined raltitrexed for intraperitoneal chemotherapy with Oxaliplatin combined with oral Tegio chemotherapy,was performed on cases in observation group while treatment with Oxaliplatin combined with oral Tegio chemotherapy only was performed on cases in control group.A comparative study was made to the clinical effect,the relevant toxicity indicators,adverse reactions,survival rates and so on.Results The recovery time of bowel function in the observation group and control group was(5.33±0.95)d and(5.15±0.97)d respectively without significant difference(P>0.05).There was no significant difference in relevant toxicity indicators and adverse reactions between the two groups(P>0.05).There was no significant difference in white blood cell count(WBC),neutrophile granulocyte(NE),hemoglobin(Hb),platelet count(PLT),aspartate aminotransferase(AST),alanine aminotransferase(ALT)and serum creatinine(Cre)between the observation group and the control group after treatment(P all>0.05).The recurrence rates at 12,36 and 60 months,which in the observation group and the control group were 4.44%,13.33%,40.0%,15.56%,31.11%and 71.11%,respectively.The recurrence rates at 36 and 60 months after surgery in the observation group were less than those in the control group,which were with statistically significant differences(P<0.05).The 5-year overall survival rate of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).Conclusion The combination of intraperitoneal perfusion and postoperative Oxaliplatin combined with oral Tegio chemotherapy in the elderly with advanced gastric cancer has a good safety and may be effective in the long-term prognosis.