【摘要】 目的研究术中动脉灌注化疗(IAIC)联合腹腔区域缓释化疗对进展期胃癌患者术后复发、转移及生存的影响。方法将2007年8月至2010年8月于医院住院手术的120例进展期胃癌患者随机分为试验组和对照组,每组60例。试验组患者接受术中动脉灌注5-Fu 1 000 mg联合标准胃癌D2根治术,关腹前将缓释型5-Fu分散放置于瘤床及其淋巴回流区。对照组患者则行单纯标准胃癌D2根治术,腹腔内不涉及干预性处理。术后两组患者均接受相同方案的术后辅助化疗,随访周期为5年。比较两组患者的并发症及不良反应发生情况、术后局部复发率、转移率及生存率。结果两组患者术后并发症的发生率、不良反应发生率及术后1年生存率比较,差异均无统计学意义(P>0.05)。试验组患者局部复发率、肝脏转移率及腹腔转移率明显低于对照组,3年生存率、5年生存率明显高于对照组(P<0.05)。结论 IAIC联合腹腔区域缓释化疗能够减少进展期胃癌患者的复发转移,使其生存获益,而且安全性高,操作简便。更多还原

【Abstract】 Objective To study the effects of intraoperation artery infusion chemotherapy(IAIC) combined with intraperitoneal sustained-release chemotherapy on postoperative recurrence, metastasis and survival of patients with advanced gastric cancer. Methods A total of 120 patients with advanced gastric cancer who hospitalized in hospital from August 2007 to August 2010 were randomly divided into experimental group and control group, with 60 cases in each group. The patients in the experimental group received intraoperative intra-arterial infusion of 1 000 mg 5-FU combined with standard gastric cancer(D2) radical surgery, and the sustained-release type 5-FU was dispersed in the tumor bed and its lymphatic recirculation zone before the abdominal closure. The patients in the control group were treated with the simple standard gastric cancer(D2) radical operation, with no intervention in the abdominal cavity. Both groups received postoperative adjuvant chemotherapy with the same protocol. The follow-up period was 5 years. The incidences of complications and adverse reactions, local recurrence rate, metastasis rate and survival rate were compared between the two groups. Results There were no statistical differences between the incidence of postoperative complications, incidence of adverse reactions and the 1-year survival rate between the two groups(P >0.05). The local recurrence rate, liver metastasis rate and peritoneal metastasis rate in the experimental group were significantly lower than those in the control group, the 3-year survival rate and 5-year survival rate were significantly higher than those in the control group(P<0.05). Conclusion IAIC combined with intraperitoneal sustained-release chemotherapy can reduce the recurrence and metastasis of patients with advanced gastric cancer, resulting in more survival benefits, with higher safety and easier operation.更多还原