活性碳吸附丝裂霉素C腹腔化疗预防进展期胃癌术后复发

目的　探讨活性碳吸附丝裂霉素C(MMC)腹腔化疗治疗和预防进展期胃癌术后腹腔复发的效果。　方法　通过随机临床试验 ,将 12 4例进展期胃癌病例随机分为 2组 ,实验组于手术结束时腹腔内给予经医用活性碳吸附的MMC 5 0mg ,术后 3个月开始常规静脉化疗。对照组仅于手术后 3周开始静脉化疗。全部病例均采取根治性手术治疗。　结果　实验组和对照组总的 3、5年生存率分别为 70 16 % ,44 5 1%和 2 7 0 9% ,14 4 5 % ,P <0 0 1。实验组较对照组 3、5年生存率分别提高 43 0 7%及 30 0 6 %。　结论　活性碳吸附MMC腹腔化疗能提高进展期胃癌根治性手术后无瘤生存率。其作用仅限于杀死腹腔内游离的癌细胞和淋巴结内微转移癌灶 ,因此主要适用于经根治手术的高危患者。

Prospective randomized trial of prophylaxis of postoperative peritoneal carcinomatosis of advanced gastric cancer: intraperitoneal chemotherapy with mitomycin C bound to activated carbon particles

Objective To evaluate the beneficial effect of intraperitoneally applied mitomycin bound to actived carbon particles (MMC-CH) in the prevention and treatment of intraabdominal recurrence after curative surgery for gastric cancer. Methods One hunderd and twenty-four patients with radically resected gastric cancer infiltrating the serosal surface were randomly divided into group receiving 50 mg mitomycin bound to a solution of 375 mg carbon adsorbent intraperitoneally before closure of the abdominal wound (n=62) and a control group (n=62). The patients with MMC-CH and the control group were received systemic chemotherapy 3 months or 3 weeks after operation respectively. The postoperative recurrence-free survival was evaluated to analyze the benefits of this treatment. Results After observation for 8 months (range,2-65). The 3-,5-year postoperative recurrence-free survival rates were significantly higher in the MMC-CH group (70.16%,44.51%) than in the control group(27.09%,14.45%), P<0.01. Conclusion Adjuvant intraperitoneal chemotherapy of gastric cancer by mitomycin bound to actived carbon particles is effected by an increased postoperative recurrence-free survival rate.