进展期胃癌患者术中低渗热灌注化疗临床疗效分析

目的 观察术中腹腔低渗热灌注化疗对进展期胃癌患者术后临床疗效.方法 将施行胃癌根治术88例进展期胃癌患者随机分为低渗热化疗组30例,术中予以腹腔低渗热灌注化疗;等渗热化疗组31例,术中等渗热灌注化疗;对照组27例,术中腹腔不作任何灌注化疗.观察比较三组患者的手术并发症发生率和术后长期生存率.结果 手术并发症发生率三组患者间的差异性无显著性意义(P＞0.05).5年生存率低渗热化疗组64%,等渗热化疗组59%,显著高于对照组32%.但两个热化疗组比较,差异无显著意义(P=0.521),分别与对照组比较,P=0.0085和P=0.0321.低渗热化疗组9例复发,复发时间(24.6±9.7)个月;等渗热化疗组13例复发,复发时间(15.6±8.7)个月;对照组15例复发,复发时间(10.2±5.2)个月.低渗热化疗组复发时间显著晚于对照组和等渗热化疗组,(分别为P=0.0021,P=0.0345),而等渗热化疗组晚于对照组(P=0.0425).结论 低渗热化疗与等渗热化疗均能提高患者的生存率,低渗热化疗在延缓肿瘤复发上优于等渗热化疗.

Intraoperative intraperitoneal hypotonic thermoperfusion chemotherapy for advanced gastric cancer

Objective To investigate the effectiveness of intraoperative intraperitoneal hyoptonic thermoperfusion chemotherapy(HTC) for advanced gastric cancer(AGC).Methods 88 patients with advanced gastric cancer were randomly assigned into 3 groups:HTC group(n=30) received intreaperitoneal perfusion with heated hypotonic cisplatin solution immediately after radical gastrectomy;isotonic thermoperfusion chemotherapy group(ITC,n=31) received intraperitoneal perfusion with heated isotonic cisplatin solution immediately after radical gastrectomy and the control group(n=27) in whom only radical gastrectomy was performed with no perfusion therapy.Morbidity and survival rate were compared among the 3 groups.Results There were no significant differences in morbidity among the three groups(P>0.05).The 5-year survival rates of HTC group(64%) and ITC group(59%) were significantly higher than those of control group(32%)(P=0.0085 and P=0.0321,respectively),but there were no significant differences between HTC group and ITC group(P=0.521).Time to relapse was significantly longer in HTC group than in ITC group and control group(P=0.0021 and P=0.0345,respectively).Conclusion Both HTC and ITC can improve survival rate of patients with advanced gastric cancer,HTC can delay relapse as compared with ITC.