胃癌术中低渗温热腹腔化疗联合术后早期腹腔化疗的疗效观察

背景与目的:胃癌脱落细胞引起的腹腔内肿瘤复发是中晚期胃癌患者治疗失败的重要原因,腹腔内化疗可以有效地杀灭腹腔脱落细胞。本研究拟探讨术中即时低渗温热腹腔化疗联合术后早期腹腔化疗的应用价值。方法:156例胃癌患者随机分为术中即时低渗温热腹腔化疗联合术后早期腹腔化疗组(治疗1组)、单纯术中即时低渗温热腹腔化疗组(治疗2组)和未行腹腔化疗组(对照组)。结果:治疗1组的2年生存率为84.4%,对照组为65.2%,差异有显著性(P<0.05);治疗1组的3年生存率为71.1%,明显高于治疗2组(50.0%)和对照组(45.6%)(P<0.05)。治疗1组肝转移的发生率为7.7%,明显低于对照组(27.3%)(P<0.01);治疗2组肝转移的发生率为10.2%,明显低于对照组(27.3%)(P<0.05)。结论:术中即时低渗温热腹腔化疗联合术后早期腹腔化疗对胃癌有确实的疗效,腹腔化疗对胃癌术后肝转移有确实的预防效果。

Efficacy of intraoperative hypotonic peritoneal chemo-hyperthermia combined with early postoperative intraperitoneal chemotherapy on gastric cancer

BACKGROUND & OBJECTIVE: Abdominal recurrence from exfoliated cancer cells contributes a lot to treatment failure of advanced gastric cancer. Intrape ritoneal chemotherapy, which has been proved effective in eliminating exfoliated cancer cells in abdominal cavity, is a hot topic on treatment of gastric cancer . This study was to explore application of combined therapy of intraoperative hy potonic peritoneal chemo-hyperthermia and early postoperative intraperitoneal ch emotherapy to gastric cancer. METHODS: A total of 156 gastric cancer patients we re randomized into 3 groups, and underwent the combined therapy (treatment group 1), intraoperative chemotherapy (treatment group 2), and peritoneal lavage with distilled water (control group), respectively. RESULTS: The 2-year survival rat e of treatment group 1 was significantly higher than that of control group (88.4 % vs. 65.2%, P < 0.05). The 3-year survival rate of treatment group 1 was signif icantly higher than those of treatment group 2, and control group (71.1% vs. 50. 0%, and 45.6%, P < 0.05). Occurrence of liver metastasis was significantly lower in treatment groups 1 and 2 than in control group (7.7%, and 10.2% vs. 27.3%, P < 0.05). CONCLUSIONS: Combined therapy of intraoperative hypotonic chemo-hypert hermia and early postoperative intraperitoneal chemotherapy is effective for gas tric cancer. Intraperitoneal chemotherapy can be used to prevent postoperative l iver metastasis of gastric cancer.