动脉置泵化疗在晚期胃肠道肿瘤治疗中的应用

目的　评价术中动脉内置泵、术后皮下泵内区域灌注化疗晚期胃肠道肿瘤的疗效。方法　随访观察 79例手术证实不能切除的晚期胃肠道肿瘤患者 ,经术中肿瘤供血动脉内置泵 ,术后泵内灌注化疗后的疗效。其中胃癌 4 2例 ,直肠癌 2 6例 ,结肠癌 11例。结果　化疗后 ,完全缓解者(CR) 1例 ;部分缓解者 (PR) 6 9例 ,其中 11例行二次根治性癌肿切除术 ;稳定者 (NC) 9例 ;无 1例恶化者 (PD)。有效率 88.6 % (70 / 79)。置泵术后生存满 1、2、3年者分别为 83.5 (6 6 / 79)、2 7.8(2 2 / 79)、8.9% (7/ 79) ,平均生存期为 2 0 .6个月。结论　术中动脉内置泵 ,术后泵内区域灌注化疗是治疗晚期胃肠道肿瘤的有效方法 ,可以延长患者的生存期 ,提高手术切除率。

Regional intraarterial chemotherapy through pump placed in the artery in treatment of the later gastrointestinal cancer

Objective To evaluate the effect of operative pump-insertion into the artery, postoperative regional intraarterial infusion chemotherapeutic medicine through pump placed in the artery for treatment of late-stage gastrointestinal cancers. Methods The pumps for chemotherapy were placed in the tumorous nutritious artery during operation in 79 patients with unresectable gastrointestinal cancers. The chemotherapeutic medicine was infused through the pump after operation and the treatment effect was observed. Among these patients, 42 cases had gastric cancer, 26 cases rectal cancer, 11 cases colonic cancer. Results Complete response (CR) was achieved in 1 cases; part response (PR) in 69 cases, no changes (NC) in 9 cases, 11 cases patients underwent secondary resection after intraarterial chemotherapy. The effective rate was 88.6%. One, two and three years survival rates was 83.5%, 27.8% and 8.9% respectively. The average survival period were 20.6 months. Conclusions Pump-insertion into the artery and regional intraarterial chemotherapy is efficient in treatment of the late-stage gastrointestinal cancer, which can colonic the survival period of patients, and increase the resectable rate.