术中动脉灌注化疗于胃癌根治术中的应用研究进展

胃癌发病率死亡率均较高，早期胃癌行根治性切除术后复发转移率较低，但进展期胃癌（AGC）即使行R0切除术后复发转移率仍较高，究其原因为外科手术治疗无法根除肿瘤微转移灶。术中动脉灌注化疗（IAIC）能使肿瘤及肿瘤周围组织形成高化疗浓度场所，杀灭外科根治术后残留癌细胞。对AGC行肿瘤R0切除加D2淋巴结清扫配合IAIC能达到宏观及微观上的根治，降低肿瘤的复发转移概率，延长患者生存时间，提高生存质量。IAIC起源于20世纪90年代，经过近30年的发展，其临床效果已得到认可，但缺乏相关大宗随机试验证据支持，其灌注血管选择、用药方案选择等仍未得到规范。本文就IAIC的研究现状做一综述，为相关临床工作提供参考。

Application of intraoperative artery infusion chemotherapy in gastric cancer surgery

Gastric cancer has a high morbidity and mortality. The rate of metastasis and recurrence in early gastric cancer that has undergone radical surgery is low. However, the rate of metastasis and recurrence in advanced gastric cancer (AGC) after curative gastrectomy is high. The reason is that surgical treatment cannot eradicate tumor micro-metastases. Intraoperative arterial infusion chemotherapy (IAIC) can create a high concentration chemotherapy circumstance around the tumor and surrounding tissues, which will kill residual cancer cells following curative gastrectomy. AGC patients after R0 resection with D2 lymph node clearance and IAIC can achieve a radical cure with regard to both macroscopic and microscopic evidence, which will decrease the rate of metastasis and recurrence, prolong patients′ survival time, and improve their quality of survival. IAIC was first developed in the 1990 s, and with nearly 30 years of development, its clinical efficacy has been recognized. However, there is still no large randomized trial evidence to support its efficacy, and it is still not optimized on how to choose blood vessels for perfusion and how to choose a proper chemotherapy regimen. This article summarizes the application of IAIC in AGC patients.