术中动脉灌注化疗联合腹腔灌注化疗对胃癌患者预后的影响

目的：探究术中动脉灌注化疗（intraoperation artery infusion chemotherapy,IAIC）联合腹腔灌注化疗对胃癌患者预后的影响。方法：筛选2006年3月-2007年9月就诊于我科的91例年龄≤75岁的胃癌患者随机分为实验组（47例）和对照组（44例）。实验组术中经瘤体的主要供血动脉及腹腔共给予5-氟尿嘧啶1000mg及丝裂霉素10mg,对照组给予等体积生理盐水后单纯行常规手术切除,术后两组患者均给予FAP方案（5-氟尿嘧啶600mg/m2d1、丝裂霉素30mg/m2 d1、顺铂20mg/m2 d1-5）化疗,总疗程4-6次。结果：实验组1年、2年、3年生存率分别为89.36%、76.09%、58.70%。3年局部复发率、腹腔转移率、肝脏转移率分别为26.09%、15.22%、21.74%。对照组1年、2年、3年生存率分别为90.91%、60.47%、32.56%。3年局部复发率、腹腔转移率、肝脏转移率分别为46.51%、25.58%、18.60%。中位生存时间实验组为36个月,而对照组为27个月。两组间3年腹腔转移率差异较大,但无统计学意义（P〉0.05）。3年生存率及局部复发率的差异有统计学意义（P〈0.05）。结论：术中动脉灌注联合腹腔灌注5-氟尿嘧啶及丝裂霉素,可有效提高患者的远期生存率,同时降低局部复发率。并对腹腔转移率的降低可能有意义。

Efficacy of intraoperation artery infusion chemotherapy combined with intraoperation intraperitoneal chemotherapy to treat respectable gastric cancer without preoperative chemotherapy

Objective：To test whether intraoperation artery infusion chemotherapy（IAIC）combined with intraoperation intraperitoneal chemotherapy（IIC） can improve survival in respectable gastric cancer.Methods：Total of 91 patients aged ≤75 years,who had histologically proven gastric cancer,and randomly assigned them by minimization to receive either： Intraoperation artery infusion chemotherapy（5-Fluorouracil 750mg and Mitomycin 8mg） combined with intraoperation intraperitoneal chemotherapy（5-Fluorouracil 250mg and Mitomycin 2mg）（n=47） and operation or only operation（n=44）.And all the enrolled patients had a adjuvant radiation with the chemotherapy of FAP regimen（5-Fluorouracil 600 mg/m2 d1 and Mitomycin 30mg/m2d1 Cisplatin 20 mg/m2d1-5） after operation.Results：Patients receiving IAIC and IIC,their 1,2 and 3-year survival rates were 89.36%,76.09%,58.70%,while patients receiving only operation were 90.91%,60.47%,32.56%.The 3-year local recurrence rate,3-year abdomen metastasis rate and 3-year liver metastasis rate in patients receiving IAIC and IIC were 26.09%,15.22%,21.74%,while 46.51%,25.58%,18.60% in the other group.And the difference in 3-year survival rate and 3-year local recurrence rate between the two groups had statistical differences.Conclusion：Intraoperation artery infusion chemotherapy（IAIC）combined with intraoperation intraperitoneal chemotherapy using 5-Fluorouracil and Mitomycin can induce the local recurrence rate and improve the long-term survival.