中西医结合治疗胃癌肝转移疗效分析

目的:评价肝动脉化疗栓塞(TACE)联合全身静脉化疗治疗胃癌肝转移的疗效及其影响因素。方法:回顾分析2006年5月—2012年7月在本科接受TACE联合全身静脉化疗的胃癌肝转移病例51例,所有病例先行1³周期全身静脉化疗(EOF方案或TOF方案),化疗期间患者同时接受参麦注射液静脉滴注,化疗结束后33周期全身静脉化疗(EOF方案或TOF方案),化疗期间患者同时接受参麦注射液静脉滴注,化疗结束后3⁴周行肝动脉化疗栓塞(TACE)治疗。结果:所有病例接受TACE联合全身静脉化疗,客观有效率62.0%,获益率78.4%。单纯肝转移客观有效率、1年生存率分别为85.0%、80.0%,合并肝外转移组分别是46.9%、54.8%,单纯肝转移组高于合并肝外转移组(P<0.05)。单发或孤立性肝转移组客观有效率、1年生存率分别为83.3%、88.9%,多发肝转移组分别是51.5%、51.5%,单发或孤立性肝转移组高于多发肝转移组(P<0.05)。富血供型客观有效率、1年生存率分别为86.4%、92.3%,少血供型客观有效率、1年生存率分别为55.3%,55.2%,富血供型高于少血供型(P<0.05)。结论:TACE联合全身静脉化疗治疗胃癌肝转移有较高的客观有效率,尤以单发或孤立性肝转移、不合并肝外转移、DSA造影富血供型疗效更好。

Integrative Medicine Clinical analysis of gastric cancer metastasis

Objective ：To evaluate the efficacy of hepatic arterial chemoembolization （TACE） combined with systemic intrave nous chemotherapy on liver metastasis of gastric cancer and its influencing factors. Methods：From May 2006 to July 2012,51 cases gastric cancer with liver metastases patients which accepted TACE combined with systemic chemotherapy treatment were retro spective analysised. All patients received 1 3 cycles prior systemic chemotherapy （ EOF programs or TOF program）, during chemotherapy,patients received intravenous infusion of Shenmai Zhusheye, 3 4 weeks after the end of chemotherapy received transcatheter arterial chemoembolization （TACE）therapy. Results：All patients received TACE combined with systemic chemothera py,objective response rate was 62.0% ,benefit rate was 78.4% . The objective response rate and 1 year survival rates of the patients with liver metastases alone were 85.0 % ,80.0%, which were higher the theextrahepatic metastasis patients which were 46. 9% and 54. 8 % （P 〈 0. 05 ）. The objective response rate, 1 year survival rates of single or isolated liver metastasis were 83. 3 % and 88.9% , they were higher than the Multiple liver metastases patients which were 51.5% ,51.5 % （P 〈 0. 05 ）. The objec tive resnonse rate and 1 year survival rates of the rich：blood suDnlv tvDe oatients were 86.4% .92.3% . they were hiher thanthe less blood supply type patients Whichwere 55.3% , 55.2% （P 〈 0. 05 ）. Conclusion：TACE combined with systemic chemother apy treatment on gastric cancer liver metastases have a higher objective response rate, especially on single or isolated liver metas tases without extrahepatic metastasis, DSA angiography rich blood supply type patoents.