手术加吡柔比星腹腔灌注及联合化疗治疗中晚期食管癌贲门癌的疗效观察

目的探讨中晚期食管癌、贲门癌手术切除加吡柔比星腹腔灌注及术后静脉联合化疗的治疗效果.方法 390例食管癌、贲门癌患者随机分为观察组(140例)和对照组(250例).观察组术中用吡柔比星50 mg、5-Fu 500 mg、卡铂300 mg等腹腔灌注.两组均于手术后2～3周采用CBP/DDP+THP+5-Fu或DDP+5-Fu+CBP及CBP/DDP+TAX+5-Fu或CBP/DDP+HCPT+5-Fu等多种方案交替静脉联合化疗,4周为一疗程,共4～6个疗程.随访3年进行疗效比较.结果观察组1,2,3年生存率分别为95.7%、81.4%和75.0%,对照组依次为87.2%、69.6%和56.0%.观察组1,3年淋巴转移率分别为3.6%和20.7%,对照组为12.0%和40.8%.毒副反应两组无明显差异.结论中晚期食管癌、贲门癌手术加腹腔灌注,辅以早期静脉联合化疗,可相应提高患者生活质量及生存率.

Efficacy of surgery and intraperitioneal priarumbicin (THP) perfusion combined with intravenous chemotherapy in treatment of advanced esophageal and cardiac carcinomas

Objective To evaluate the efficacy of surgery and intraperitioneal pirarumbicin , 5-Flueroura-cil (5-Fu) and caboplatin (CBP) perfusion combined with intravenous chemotherapy in the treatment of esophageal and cardiac carcinomas. Methods The advanced esophageal and cardiac cancer patients (390 cases) were divided into observation group (140 cases) and control groups (250 cases) . The observation group was treated with THP, 5-Fu, GBP intrapertioneal perfusion chemotherapy. All of two groups (390 cases) received alternate intravenous chemotherapy of CBP/DDP + THP + 5-Fu or DDP + 5-Fu + CBP regimens and CBP/DDP + TAX + 5-Fu or CBP/DDP + HCPT + 5-Fu regimens in 2- 3 weeks after surgery and repeat every 4 weeks . The patients had 4 to 6 therapeutic courses . The follow-up survey was compared after the treatment between two groups. Result 1,2, 3 years survival rates were 95. 7%, 81.4% and 75.0% in the observation group as compared with 87.2%, 69.6% and 56.0% in the control group respectively. 1-, 3-years lymph metastasis rates of the observation and control group were 3.6% , 20.7% and 12.0% , 40.8% respectively.There was no significant difference in the side-effects between the two groups. Conclusion Operation plus intraperitioneal THP perfusion combined with intravenous chemotherapy is an effective way for treatment of the advanced esophageal and cardiac carcinomas, and it can improve the life quality and survival rates of the patients.