胃癌手术后局部灌注化疗预防局部复发和肝转移的临床研究

目的　探讨胃癌术后局部灌注化疗预防局部复发和肝转移的价值。方法　将收治的 3 5 2例胃癌术前随机分为两组,治疗组术后行局部动脉灌注化疗 ( 1 8 4例 );对照组术后行全身静脉化疗( 1 6 8例 ),对两组的疗效进行比较。结果　随访时间 3 ~ 6 年,随访 3 2 8 例,失访 2 4 例,随访率93. 2%。治疗组 1, 3, 5 年生存率分别为 9 5. 7% , 7 8. 3% , 4 6. 3% ;对照组是 8 6. 8% , 4 8. 2% ,21. 4%。局部复发率和肝转移率治疗组为 9. 2% , 1 2. 5% ,对照组为 2 2. 0% , 2 6. 8%。两组上述各项指标差异均有显著意义 (均P< 0. 0 1 )。结论　局部灌注化疗是胃癌术后预防局部复发和肝转移的一种有效方法,其疗效明显优于术后全身静脉化疗,且毒副作用小。

Clinical study of regional infusion chemotherapy for prevention of local recurrence and hepatic metastasis after radical resection of gastric carcinoma

Objective To evaluate the value of regional infusion chemotherapy for prevention of local (recurrence) and hepatic metastasis after radical resection of gastric carcioma.Methods 352 patients with (gastric) carcinoma undergoing radical operation were preoperatively randomly divided into 2 groups:Regional (infusion) chemotherapy(treatment group,184 cases) and peripheral venous chemotherapy(control group,168 cases).Results 328 cases(93.2%) were followed-up for 3 to 6 years,and 24 cases were lost to follow up.The 1-,3- and 5-year survival rate was 95.7%,78.3% and 46.3%,respectively,in the (treatment) group,and 86.8%,48.2% and 22.0%,respectively in the control group.The local recurrence rate and hepatic metastasis rate was 9.2% and 12.5%,respectively,in the treatment group; and was (22.0)% and 26.8%,respectively,in the control group.Conclusions Regional infusion chemotherapy is (effective) for prevention of local recurrence and hepatic metastasis after radical operation for gastric carcinoma.It is better than peripheral venous chemotherapy and has less toxic side effects.