热疗联合化疗治疗晚期胃癌的疗效和安全性观察

Efficacy and Safety of Hyperthermia Combined with Chemotherapy for Advanced Gastric Cancer

目的探讨热疗联合化疗治疗晚期胃癌的安全性及近远期疗效。方法将77例晚期胃癌患者随机分为热化疗联合组和单纯化疗组。给予2个周期治疗后对2组患者的治疗疗效及生活质量进行评定;同时观察并统计2组患者治疗期间不良反应发生情况。结果治疗结束后单纯化疗组有效率为34.2%(13/38),低于热化疗联合组(59.0%,23/39),2组比较差异有统计学意义(P<0.05);热化疗联合组患者远期生存率与单纯化疗组比较差异未见统计学意义(P>0.05)。2组患者发生的不良反应主要有骨髓抑制、肝肾损害、胃肠道反应及周围神经毒性反应等,2组患者不良反应发生率比较差异均无统计学意义(P>0.05)。治疗结束后热化疗联合组患者的生活质量评分部分项目的得分优于单纯化疗组,差异有统计学意义(P<0.05)。结论晚期胃癌患者采用热疗有利于增强化疗作用,且不增加不良反应发生率,可以在临床中推广使用。

Objective To explore the safety and efficacy of hyperthermia and chemotherapy in the treatment of advanced gastric cancer. Methods 77 patients with advanced gastric cancer were randomly divided into combined treatment group and chemotherapy group. After 2 treatment cycles,efficacy and the quality of life of the 2 groups were compared,and side effects were recorded during the treatment. Results The response rate in the chemotherapy group was 34. 2%( 13 /38),which was significantly lower than 59. 0%( 23 /39) of the combined treatment group( P < 0. 05). There was no significant difference in the longterm survival rate between the 2 groups( P > 0. 05). The main adverse reactions included bone marrow depression,liver and kidney damage,gastrointestinal reactions and peripheral nerve toxicity. There was no significant difference in the adverse reactions rate between the 2 groups( P > 0. 05). After treatment,quality of life scores in some items in the combined treatment group were significantly higher than those of the chemotherapy group( P < 0. 05). Conclusion Hyperthermia can improve the efficacy of chemotherapy for advanced gastric cancer without increase incidence of adverse reactions,it can be clinically applied.