老年进展期胃肠道肿瘤术后腹腔化疗的临床疗效观察

Effect of postoperative intraperitoneal chemotherapy on advanced gastrointestina l carcinoma of senile patients

目的 探讨老年进展期胃肠道肿瘤术后腹腔化疗的临床疗效。方法 对 1992年 1月至 1997年 10月 178例 60岁以上行根治性手术后的老年进展期胃肠道肿瘤术后行腹腔化疗的病例进行回顾性分析。并将之与同期行常规静脉化疗的 12 4例进行分析比较。结果 178例腹腔化疗病人中 165例完成 6个疗程的全部化疗 ,完成率为 92 .7%。 12 4例静脉化疗病人中只有 85例完成全部的 6个疗程的化疗 ,完成率为 68.5%。 2年生存率(60 6% )、3年生存率 (55 8% )、5年生存率 (51 5% )高于静脉化疗组 (45 9%、41 1%、3 7 6% ) (P <0 0 5)。结论 老年进展期胃肠道肿瘤术后行腹腔化疗 ,药物的毒副反应小 ,病人耐受性好 ,化疗后腹腔转移率 ,肝转移率和血清肿瘤标记物水平明显低于静脉化疗组 ,术后

Objective To evaluate the effect of postoperative intraperi toneal chemotherapy on advanced gastrointestinal carcinoma of senile patients. Method s From January 1992 to October 1997, 178 senile patients (>60 years old) with advanced gastrointestinal carcinoma were treated with intraperitoneal chemothera py after radical operation in our hospital. At the same time, we compared them with intravenous chemotherapy.Results One hundred and sixty five ca ses(92.7%) i n the intraperitoneal chemotherapy group received all the 6 phases of chemothera py, but only 85 cases(68.5%) in intravenous chemotherapy group completed all t he 6 phases of chemotherapy. The 2 year survival rate (60.6%), 3 year survival r ate (55.8%) and 5 year survival rate (51.5%) in the intraperitoneal group were m uch higher than those in intravenous chemotherapy patients (45.9%, 41.1%, 37.6%, respectively)(P<0.05).Conclusion For senile patients with advanced gastro intestinal carcinoma, treatment with intraperitoneal chemotherapy after radical operation has less side effect and good toleration. Compared with intravenous ch emotherapy, it has advantages of lower metastasis rate, lower hepatic met astasis rate, lower level of CEA and CA19 9 and higher 5 year survival rate.