含紫杉醇两药方案联合腹腔灌注化疗治疗合并腹腔种植转移的晚期胃癌临床观察

目的 探讨紫杉醇为基础的两药化疗方案联合腹腔灌注化疗（IPC）对合并腹腔种植转移的晚期胃癌患者的临床疗效.方法 对初治的173例合并腹腔种植转移的晚期胃癌患者的临床资料进行回顾性分析.其中116例采用紫杉醇为基础的两药静脉化疗方案联合IPC（全身化疗＋IPC组）,57例单纯采用紫杉醇为基础的两药静脉化疗方案（全身化疗组）.分析纳入观察病例的临床特征,包括性别、年龄、病理分级、美国东部肿瘤协作组（ECOG）评分、无进展生存期时间（PFS）及总生存时间（OS）.采用Kaplan-Meier法及多因素COX回归模型分析IPC对晚期胃癌生存的影响.结果 173例合并腹腔种植转移的晚期胃癌患者,中位随访15.5个月,中位PFS 5.81个月,中位OS 10.30个月.全身化疗＋IPC组中位PFS 6.6个月,中位OS 11.1个月;全身化疗组中位PFS 5.0个月,中位OS 10.1个月.全身化疗＋IPC组PFS优于全身化疗组（P＜0.05）,2组间OS差异无统计学意义（P＞0.05）.多因素COX回归分析结果显示,ECOG评分、有无ICP是影响合并腹膜种植转移的晚期胃癌患者PFS、OS的独立预后因素.2组主要毒性反应包括消化道反应、肝功能异常、骨髓抑制（主要是粒细胞下降）,2组间毒性反应差异无统计学意义（P＞0.05）.结论 含紫杉醇两药方案全身化疗联合ICP治疗合并腹腔种植转移的晚期胃癌能提高疗效、延长生存期,且耐受性较好.

Paclitaxel- based two -drug regimens combined with intraperitoneal chemotherapy for advanced gastric cancer with peritoneal dissemination

Objective To evaluate the efficacy and safety of paclitaxel - based two - drug regimens combined with in- traperitoneal chemotherapy （IPC） for advanced gastric cancer with peritaneal dissemination. Methods The clinical data from 173 advanced gastric cancer patients with peritoneal dissemination were retrospectively analyzed. Among the 173 ca- ses, 116 cases received paclitaxel - based intravenous route two - drug regimens combined with IPC （ systemic chemothera- py ＋ IPC group） and 57 cases received paclitaxel - based intravenous route two - drug regimens alone （ systemic chemo- therapy group）. The clinical features including gender, age, pathological grading, Eastern Cooperative Oncology Group （ECOG） score, progression-free- survival （PFS）, and overall survival （OS） were analyzed. The influence of IPC on survival outcomes of advanced gastric cancer were investigated using Kaplan - Meier method and Cox regression model. Re- sults With a median follow - up of 15.5 months, in 173 cases of advaced gastric cancer with peritaneal dissemination, the median PFS was 5.81 months and median OS was 10. 30 months. The median PFS in patients with IPC was significantly longer than in patients without IPC （6.6 vs. 5.0 months, P 〈 0.05 ）. Multivariate COX regression analysis showed that the ECOG score and IPC were the significant defining factors for PFS and OS. There was no statistically significant difference in the predominant toxicity between the patients receiving IPC and patients not receiving IPC. Conclusion Paclitaxel - based two -drug regimens combined IPC is well tolerated and effective for gastric cancer patients with peritoneal dissemination.