胃恶性肿瘤术前介入治疗的基础和临床研究

观察胃恶性肿瘤术前介入治疗的临床疗效探讨及其作用机制。方法：对４２０例胃恶性肿瘤患者术前采用Ｓｅｌｄｉｎｇｅｒ选择性动脉插管法进行化疗，方案为： ５－ＦＵ５００～７５０ｍｇ／ｍ２，表阿霉素４０ｍｇ／ｍ２，丝裂霉素１０ｍｇ／ｍ２或顺铂６０ｍｇ／ｍ２，直接注入肿瘤的主要供血动脉。动脉化疗后７～１０天，全部病人接受了手术治疗，对切除的标本进行详细组织病理学研究，观察介入治疗后的组织病理学改变。结果：本组总有效率为７２．８％，３例显效。经对比研究发现，介入治疗后小动脉炎和血管周围炎引起的肿瘤组织血供障碍和肿瘤组织病理性坏死是产生治疗效果的主要原因之一。结论：胃恶性肿瘤术前介入治疗效果明显，副作用轻，可以成为胃恶性肿瘤总体治疗中的一种重要的辅助治疗方法。

Pre-operative Transcatheter Arterial Chemotherapy for Gastric Malignancies

To study the effect of pre-operative transcatheter(Seldinger's technique ) arterial chemotherapy(TAC) on gastric cancer. Methods: 420 cases of gastric cancer received TAC 7-10 days before operation. The drugs used were 5-FU 500-750mg/m2, epirubicin 40mg/m2 and MMC 10mg/m2 or CDDP 60mg/ m2. Curative total or subtotal gastrectomy was performed in 189 patients, relatively curative in 90, palliative in 106, and simple laparotomy in 35. Histopathological changes were studied in all the specimens. Results: The overall response rate was 72.8%, and in 3 cases of early gastric cancer, the results were remarkable. The main mechanism of local chemotherapy in gastric cancer was inducing necrosis in cancer tissue by causing arteritis and thrombosis of the vessels supplying the tumor. Conclusions: This new adjuvant chemotherapy was profitable for patients with gastric cancer and produced negligible side-effects.