胃癌根治术中及术后早期腹腔热低渗灌注化疗82例报告.pdf

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1、-12·中国实用医刊2014年7月第41卷第13期ChineseJournalofPracticalMedicineJuly2014，~o1．41，No．13胃癌根治术中及术后早期腹腔热低渗灌注化疗82例报告陈思潮洪云峰蔡华新郭文若陈文博陈志杰黄灿华石成峰【摘要】目的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，并研究其应用方法。方法将T4a、T4b期胃癌82例患者随机分成术中即时低渗温热腹腔化疗联合术后早期腹腔化疗组(治疗组)与未行腹腔化疗组(对照组)。两组术后3～4周全身化疗，sP方案(s1+DDP)每3周1次，共6次。结果治疗组2年生存率为83．7

2、8％，对照组为61．76％，两组比较差异有统计学意义(P=0．001)；治疗组的3年生存率为70．27％，明显高于对照组(47．06％)，两组比较差异有统计学意义(P：0．002)；治疗组肝转移的发生率为8．82％，明显低于对照组的32．35％，两组比较差异有统计学意义(P<0．01)。结论术中及术后早期腹腔温热灌注化疗可提高进展期胃癌生存率，减少肝转移率，是一种安全有效的治疗方法。【关键词】胃癌；腹腔游离癌细胞；术中及术后早期腹腔热低渗灌注化疗Applicationofintraoperativehypotonicperitonealchemo-hypertherm

3、iacombinedwithearlypost-operativeintraperitonealchemotherapyfor82casesofgastriccancerCHENSi—chao，HONGYun-feng，CAIHua—xin，GUOWen-ruo，CHENWen-bo，CHENZhi-jie，HUANGCan—hua，SHICheng一ng．DepartmentofOncologicalSurgery，NananHospital，Nanan362300，China【Abstract】ObjectiveToinvestigatetheapplicatio

4、nvalueofcombinedtherapyofintraoperativehypotonicperitonealchemo—hyperthermiaandearlypostoperativeintraperitonealchemotherapyongastriccancer．MethodsEighty—twoT4aandT4bstagegastriccancerpatientswererandomlydividedintotwogroups，andpatientsinthetreatmentgroupunderwentthecombinedtherapy，ando

5、nlyperitoneallavagewithdistilledwaterwasgivenforpatientsincontrolgroup．Patientsinbothgroupsacceptedveinchemo—therapywithSPschemeafteroperation．ResultsTheoverall2-yearsurvivalrateofthetherapygroupandthecontrolgroupwas83．78％and61．76％，respectively，therewassignificantdifferencebetweenthetwo

6、groups(P=0．001)．Theoverall3-yearsurvivalrateofthetreatmentgroupwas70．27％，whichwassignificantlyhigherthanthatinthecontrolgroup(47．06％)，therewassignificantdifferencebe—tweenthetwogroups(P=0．002)．Therateoflivermetastasisintreatmentgroupwas8．82％and32．35％incontrolgroup，thedifferencewassignif

7、icant(尸<0．01)．ConclusionsThecombinedappli—cationofintraoperativehypotonicchemo—hype~hermiaandearlypostoperativelyintraperitonealchemother—apyiseffectiveforgastriccancer．Intraperitonealchemotherapycanbeusedtopreventlivermetastasisforpostoperativegastriccancerpatients．【Keywords】G