进展期胃癌术中应用氟尿嘧啶缓释植入剂腹腔化疗的临床疗效

目的:探讨进展期胃癌术中应用氟尿嘧啶缓释植入剂腹腔化疗临床疗效及影响胃癌预后因素.方法:选取2010年1月至2010年12月于哈尔滨医科大学附属肿瘤医院胃肠外科行R0根治术进展期胃癌患者255例.分为3组,即A组(对照组,仅行手术治疗)、B组(腹腔化疗组,氟尿嘧啶缓释植入剂3支)、C组(腹腔化疗组,氟尿嘧啶缓释植入剂6支),观察并分析3组临床治疗效果.结果:应用氟尿嘧啶缓释植入剂腹腔化疗可延长进展期胃癌患者术后总生存时间,术后3年、5年生存率高于对照组,其中应用6支氟尿嘧啶缓释植入剂术后5年生存率要高于应用3支氟尿嘧啶缓释植入剂;三组在术后总生存时间和术后1年、3年生存率比较,差异均不具有统计学意义(P＞0.05);5年生存率,差异具有统计学意义(P＜0.05).影响胃癌预后的独立因素包括肿瘤细胞分化程度、病理N分期、病理TNM分期、清扫淋巴结总数和清扫淋巴结阳性数.结论:进展期胃癌术中应用氟尿嘧啶缓释植入剂腹腔化疗可在一定程度上提高胃癌患者术后生存率,值得在临床中应用.

The clinical efficacy of 5-fluorouracil sustained-release implants intraperitoneal chemotherapy during operation in treatment of advanced gastric cancer

Objective:To explore the clinical efficacy of 5-fluorouracil sustained-release implants intraperitoneal chemotherapy during operation in treatment of advanced gastric cancer and prognosis factors.Methods:All 255 cases with advanced gastric cancer from January 2010 to December 2010 in the department of gastrointestinal surgery of the affiliated tumor hospital of Harbin Medical University were studied retrospectively.All patients were given standard R0 radical surgery,and divided into three groups,such as A group (control group,only R0 radical surgery),B group (R0 radical surgery and intraperitoneal chemotherapy,given 3 ramus 5-fluorouracil sustained-release implants),C group (R0 radical surgery and intraperitoneal chemotherapy,given 6 ramus 5-fluorouracil sustained-release implants).The clinical efficacy of the three groups were observed and analyzed.Results:Using the 5-llnorouracil sustained-release implants intropritoneal chemotherapy in treatment of advanced gastric cancer could prolong the overall survival time after operation.The 3-year and 5-year survival rate were higher than control group.In with C group,the 5-year survival rate was higher than B group.The difference of the overall survival time after operation and the 1-year,3-year survival rate among the three groups were not significant (P ＞ 0.05).However,the 5-year survival rate among the three groups were significant (P ＜ 0.05).The factors of tumor cell differentiation,the node of pathology stage,the TNM of pathology stage,the total of scavenging lymph nodes and the positive total of scavenging lymph nodes were the independent factors,which influencing the prognosis of patients with advanced gastric cancer.Conclusion:The intraperitoneal chemotherapy with 5-fluorouracil sustained-release implants during operation for advanced gastric cancer is feasible.To some extent,it could improve the survival rate of patients and is worthy of clinical application.