胃癌根治术中腹腔温热化疗结合MMC-CH疗效评价

目的:探讨胃癌根治术中腹腔温热低渗化疗结合术后活性碳吸附丝裂霉素C(MMC-CH)腹腔化疗对进展期胃癌术后疗效的影响。方法:将72例进展期胃癌病例随机分为两组,实验组:手术结束前43℃蒸馏水恒温腹腔滞留15min关腹,上腹腔置化疗管,一周后活性碳(CH)375mg+丝裂霉素C50mg+37℃生理盐水100ml混悬液通过预置化疗管缓慢注入腹腔内。对照组:手术结束前43℃蒸馏水恒温腹腔滞留15min吸出关腹。实验组与对照组分别于术后2个月、1个月全身静脉化疗。全部病例均采取D2胃癌根治性手术。结果:实验组较对照组总的3、5年生存率分别为49.24%,43.46%和43.46%,35.58%;平均生存期分别为42.64±6.2个月,36.26±5.4个月;实验组较对照组3、5年平均生存率分别提高5.78%和7.88%(P<0.05)。结论:进展期胃癌术中腹腔温热低渗化疗结合MMC-CH术后腹腔化疗可提高进展期胃癌根治性手术后生存率和生存期。

The Evaluation of the Curative Effect on Intraperitoneal Chemo-hyperthermia in Combination with MMC-CH in Radical Surgery of Gastric Cancer

Objective: To evaluate the beneficial effect on intraperitoneally applied lavage of thermal hypoosmotic solution and mitomycin C bound to actived carbon particles (MMC-CH) in the prevention and treatment of intraabdoninal recurrence after radical surgery for gastric cancer. Methods: Seventy-two patients with radically resected gastric cancer infiltrating the serrosal surface were randomly divided into two groups: the experiment group receiving intraabdominal lavage of 43℃ double distiled water (DDW) and 50mg mitomycin bound to a solution of 375mg carbon absorbent intraperitoneally 7 days after operation (n=36) and the control group (n=36). The patients from the experiment group with DDW and MMC-CH and from the control group received systemic chemotherapy in two months and one month after operation respectively. The postoperative recurrence-free survival was evaluated to analyze the benefits of this treatment. Results: The 3- and 5-year recurrence-free survival rates after operation were significantly higher in the DDW AND MMC-CH group (49.24%, 43.46%) than in the control group (43.46%, 35.58%), P<0.05. Conclusion: The adjuvant intraperitoneal chemotherapy of advanced gastric cancer by intraabdoninal lavage of 43℃ DDW and mitomycin C bound to actived carbon particles are effected by an increased postoperative recurrence-free survival rates.