胃癌根治术后全身静脉化疗联合腹腔区域性化疗30例分析

目的　探讨胃癌根治术后腹腔区域性化疗的疗效。方法　治疗组 3 0例胃癌行根治性切除 (D2 、D3 )手术 ,同时术中安置腹腔化疗泵 ,术后全身静脉化疗联合腹腔区域性化疗。术后每月化疗 ,第 1天用 5 Fu 15 0 0mg DDP 60mg NS10 0 0ml经腹腔化疗泵缓慢滴入 ;第 2天全身静脉化疗 ,CF 2 0 0mg/m2 × 5天 ,5 Fu 75 0mg/m2 × 5天 ,分别加入NS 5 0 0ml静脉滴注 ,MMC 4mg加入NS 2 0ml静脉注射× 1天 ,2 8天为 1个疗程 ,连用 6个疗程。对照组 3 0例胃癌根治性切除术后仅行全身静脉化疗 ,化疗方法同治疗组。结果　治疗组 3 0例 1、2、3年复发率分别为 10 .0 %、3 3 .3 %、43 .3 %。生存率分别为 93 .3 %、80 .0 %、66.6% ,对照组3 0例 ,1、2、3年复发率分别为 3 0 .0 %、63 .3 %、73 .3 %。生存率分别为 83 .3 %、60 .0 %、40 .0 %。结论　胃癌根治术后全身静脉化疗联合腹腔区域性化疗 ,其 2、3、年生存率明显高于对照组 (P <0 .0 5 ) ,其术后肿瘤复发率明显低于对照组 (P <0 .0 5 )。胃癌根治术后辅助全身静脉化疗并联合腹腔区域性化疗 ,可延长胃癌患者术后生存期 ,提高 3年生存率。

Postoperative Intravenous Chemotherapy Plus Intraperitoneal Chemotherapy in Gastric Cancer:an Clinical Analysis of 30 Cases

Objective To evaluate the effect of postoperative intraperitoneal chemotherapy(IPC) in gastric cancer.Methods From February 1999 to February,2001,60 postoperative cases of gastric cancer were randomly divided into IPC Group(n=30) and Control Group(n=30).IPC group received IPC(DDP/5-Fu) combined with routine intravenous chemotherapy(IVC)(CF/5-Fu).The control group received only routine IVC.The incidences of postoperative recurrence of liver or peritoneum and survival rate in two groups were compared.Results In IPC group,the 1-,2-,and 3-year postoperative recurrence rates were 10.0%,33.3% and 43.3% for IPC group,and 30.0%,63.3%,and 73.3% for control group.The 1-,2-,and 3-year survival rates were 93.3%,80.0%,and 66.6% for IPC group,and 83.3%,60.0%,and 40.0% for control group.Conclusion The survival rate is significantly improved and the occurrence rate is markedly reduced in patients with postoperative IPC combined with IVC,compared with patients with IVC only.Postoperative IPC has an effect of prolonging survival period and increasing the 3-year survival rate.