腹腔热灌注化疗对胃癌术后患者免疫功能与生存的影响

目的探讨腹腔热灌注化疗对胃癌术后患者的免疫功能和疗效的影响。方法选择2008年3月至2010年6月住院治疗的64例胃癌术后患者,随机分成两组,每组各32例,对照组采用常规静脉化疗,治疗组在对照组治疗的基础上进行腹腔热灌注化疗,观察两组患者术后免疫功能与生存率。结果治疗组治疗后KPS评分为87.50%,对照组为65.62%,治疗组的生活质量改善高于对照组,P0.05;治疗组2、3年生存率(84%、62%)高于对照组(62%、53%),P0.05;对照组1、2、3年腹腔局部复发率(6.25%、9.38%和12.5%)低于对照组的3.15%、3.15%和6.25%,P0.05;治疗组CD3+、CD4+、CD4+/CD8+各值较治疗前增高,CD8+值减少,P0.01。结论腹腔循环热灌注化疗毒副反应小,无明显并发症;能显著提高胃癌患者术后的生存质量;降低胃癌患者术后的局部复发率。相比静脉化疗能明显提高胃癌患者的免疫功能。

Effect of hyperthermic intraperitoneal chemotherapy on immune function and survival rate of patients with gastrointestinal tumor resection

Objective To investigate the effects of hyperthermic intraperitoneal chemotherapy on the immune function and curative effect of cancer patients after gastrointestinal tumor surgery. Methods 64 cases from March 2008 to June 2010 were randomly divided into two groups. 32 cases in the control group were treated with conventional intravenous chemotherapy,32 cases in the treatment group were treated with hyperthermic intraperitoneal chemotherapy on the basis of the control group. The immune function and survival rate of two groups were observed. Results After treatment,KPS score of treatment group is 87. 50%,which is significantly higher than that of the control group（ 65. 62%）,P 0. 05; the 2-year,3-year survival rates of treatment group are 84% and 62%,which is visibly higher than that of the control group（ 62%,53%）,P 0. 05; the12-month,2-years and 3-years celiac local recurrence rates of treatment group are 3. 15%,3. 15% and6. 25%,which is obviously lower than that of the control group（ 6. 25%,9. 38 % and 12. 5%）,P 0. 05;after the treatment,the CD3 ＋,CD4 ＋,CD4 ＋ / CD8 ＋ values of treatment group are significantly increased; but CD8 ＋ value is obviously reduced. Conclusions The hyperthermic intraperitoneal chemotherapy has small harmful side effect and no significant complications. The method can significantly improve the quality of life in patients with gastrointestinal tumor resection and reduce the postoperative local recurrence rate. Compared to intravenous chemotherapy,The hyperthermic intraperitoneal chemotherapy can visibly improve the immune function of patients.