腹腔热灌注化疗对进展期胃癌术后的疗效观察

目的观察腹腔热灌注化疗联合静脉化疗对进展期胃癌术后的疗效及并发症。方法将我院60例接受根治性胃切除手术的进展期胃癌的患者随机分为腹腔热灌注化疗联合全身化疗组（治疗组，n=30）及单纯全身化疗组（对照组。n=30），治疗组行腹腔热灌注保留化疗4次，之后行FOLFOX4方案静脉化疗。对照组单纯FOLFOX4方案静脉化疗。对其疗效及并发症，进行对照观察。结果并发症比较：治疗组腹胀及肌酐升高的发生率均显著高于对照组（93．33％vs．16．67％，P〈0．05；13．33％vs．3．33％，P〈0．05），腹胀及肌酐升高均为Ⅰ-Ⅱ级，治疗后均恢复正常。局部复发及转移率：治疗组腹膜腔局部复发率显著低于对照组（13．33％vs．33．33％，P〈0．05），而远处转移率无显著差异（30．00％vs．33．33％，P〉0．05）。治疗组3、5年生存率分别显著高于对照组（70．00％vs．50．00％，P〈0．05，56．67％vs．33．33％，P〈0．05）。结论进展期胃癌术后进行腹腔热灌注化疗联合全身静脉化疗能够能改善局部治疗效果，提高患者远期疗效，且毒性反应可以耐受。

Clinical study on hyperthermic peritoneal perfusion chemotherapy combined with venous chemotherapy for the treatment of advanced gastric cancer

Objective To evaluate the effects and toxicities of the hyperthermic peritoneal perfusion chemo - therapy （HPPC） combined with venous chemotherapy for the treatment of advanced gastric cancer. Methods Sixty cases of advanced gastric cancer were randomly divided into treatment group and control group. One week after radical gastrectomy, 5 -Fu （500 mg,/m^2） ＋ Cisplatin （100 mg/m^2） were used for HPPC at 43℃ weekly for four weeks, then the FOLFOX4 chemotherapy plan was carried out for six months in treatment group. Whereas the control group was received FOLFOX4 chemotherapy plan for six months only. The postoperative survival rate （3 and 5 year）, side effects and complications were compared between the two groups. Results The complication of tympanites and increased creatinine in chemotherapy group was more than that in control group （93.33 % vs. 16.67 % , P 〈 0. 05 ; 13.33 % vs. 3.33 % , P 〈 0.05 ）. These complications all recovered to normal after treatment. The intraperitoneal recurrence rate in chemotherapy group was lower than that in control group （13.33% vs. 33.33%, P 〈 0.05 ）. Three -year survival rate in chemotherapy group was higher than that in control group （ 70.00% vs. 50.00% , P 〈 0.05 ）. Five - year survival rate in chemotherapy group was higher than that in control group （56.67% vs. 33.33%, P 〈0. 05 ）. Conclusion HPPC is safe, feasible, when combined with venous chemotherapy, it can improve the prognosis and raise survival rate of the advanced gastric cancer patients significantly.