晚期消化系肿瘤腹腔化疗预后探讨及不良反应的预防

目的侵及浆膜及腹腔淋巴结的消化系肿瘤腹膜种植复发是影响预后及生存质量的重要因素之一,本文探讨腹腔内化疗在防治腹膜复发的作用及不良反应的预防.方法40例癌肿侵及浆膜或有腹腔淋巴结转移的行全身+腹腔化疗(治疗组),另40例仅予全身化疗而未行腹腔内化疗(对照组)进行观察;同时观察每例前后2次腹腔化疗分别仅予化疗药(治疗组),和第2次加用利多卡因、甲基强的松龙(预防组)的不良反应预防.结果治疗组1、3、5年生存率为90.0%、72.5%、55.0%;对照组为80.0%、62.5%、37.5%.5年生存率及腹水控制率治疗组明显高于对照组(P＜0.05).在不良反应预防方面,给药组各种不良反应明显较对照组减少.结论腹腔化疗因其腹腔内药物浓度高,剂量大,全身不良反应小的优点,对恶性腹水有较好的疗效;腹腔内给予利多卡因等药物预防腹腔化疗不良反应是行之有效的方法,能减轻患者化疗的痛苦,对患者的生存期及生存质量有较大提高.

Evaluation of Intraperitoneal Chemotherapy in Patients with Advanced Digestive Malignancies

Objective:The peritoneal involvement is one of the most common death causes of digestive malignancies,In this study we evaluate the effect of intraperitoneal chemotherapy(IPC)for preventing and treating the peritoneal recurrence.Methods:Forty patients with ad-vanced digestive malignancies with intraperitoneal involvement were treated by systemic chemotherapy plus intraperitoneal chemotherapy and another40patients treated with systemic chemotherapy alone as control.Results:The1-,3-and5-year survival rates of the treated group were90%,72.5%and55%respectively.Meanwhile the1-,3-and5-year survival rates of the control group were80%,62.5%and37.5%respectively.The5-year survival rate of the treated group was higher than that of the control group(P<0.05).The side effects of the treated group who received licocaine and dexamethasone simultaneously were lower than those did not use it.Con clu sion:IPC can imporve the survival of advanced digestive malignancies with intraperi-toneal involvement and licocaine and dexamethasone can obviously decrease the side effects in patient receiving IPC.