【摘要】 目的探讨胃癌根治术中使用5-氟尿嘧啶缓释剂区域植入化疗对中期胃癌的临床疗效。方法选择2009年8月至2012年8月于四川省肿瘤医院胃肠外科诊治的186例中期胃癌患者为研究对象,将其按术中化疗药物剂型的不同选择,分成治疗组(94例,术中区域植入5-氟尿嘧啶缓释剂中人氟安800 mg)和对照组92例(术中氟尿嘧啶2 000 mg腹腔冲洗)。两组患者均行胃癌根治术(D2),术后均接受FOXFOUR方案化疗,共计6个化疗周期。记录并比较两组患者的术后并发症、药物不良反应发生情况,随访3年,记录两组术后3年生存率、局部复发率、腹腔转移率。结果两组患者术后吻合口漏、肠梗阻、腹膜炎、切口感染的术后并发症发生率比较(9.6%vs.6.5%),差异无统计学意义(χ2=0.58,P>0.05)。两组患者白细胞减少、胃肠道反应、肝功能损害的药物不良反应比较,差异也无统计学意义(P>0.05)。两组患者术后3年生存率、局部复发率和腹腔转移率比较(69.1%vs.52.2%,11.7%vs.26.1%,18.1%vs.31.5%),差异均有统计学意义(χ2值分别为5.619、6.298、4.174,均P<0.05)。结论胃癌根治术中使用5-氟尿嘧啶缓释剂区域植入化疗,能有效提高中期胃癌患者术后3年生存率,降低局部复发率和腹腔转移率,并且不会明显增加术后并发症发生率及药物不良反应发生率。更多还原

【Abstract】 Objective To explore the effect of sustained-release 5-fluorouracil intropritoneal chemotherapy in treatment of advanced gastric cancer. Methods From August 2009 to August 2012, a totale of 186 AGC(advanced gastric cancer) patients were divided into group treatment group(n=94, implant sustained-release 5-FU), control group(n=92, given 5-FU). All patients were given standard D2 radical surgery, and 6-cycle FOLFOX4 chemotherapy regime 2 weeks after operation. Complications, adverse reactions and changes of blood and functions of liver and kidney were observed. Three-year survival rates and metastasis rate of two groups were recorded. Results Two groups of patients with postoperative anastomotic leakage, intestinal obstruction, peritonitis, infection of incision, incidence of postoperative complications(9.6% vs. 6.5%), had no statistically significant difference(χ2=0.58, P>0.05). Two groups of patients with leukopenia, gastrointestinal reaction and adverse drug reactions, liver function damage differences had no statistical significance(P>0.05). Two groups of patients in three years of survival rate, local recurrence rate and celiac metastasis rate(69.1% vs. 52.2%, 11.7% vs. 26.1%, 18.1% vs. 31.5%), had statistically significant differences(χ2=5.619, 6.298, 4.174, P<0.05). Conclusions Sustainedrelease 5-fluorouracil intropritoneal chemotherapy therapy is effective on patients with advanced gastric cancer, it has important clinical value to improve the three years of survival rate, reduce the rate of cancer peritoneal metastasis and local failure and does not significantly increase the incidence of postoperative complications and the incidence of adverse drug reactions.更多还原