胃癌患者术中腹腔内温热灌注化疗的临床研究

目的探讨胃癌根治术中一次性腹腔温热灌注化疗的临床疗效。方法将术中行一次性腹腔温热灌注化疗的55例胃癌患者(治疗组)与未行此方法治疗的101例患者(对照组)的腹腔游离癌细胞检出率及预后等情况进行对比。结果治疗组的温热灌注液游离癌细胞检出率为7.3%,对照组冲洗液的癌细胞检出率为30.7%(P<0.01)。治疗组与对照组术后两年内腹腔复发率分别为14.5%和38.6%(P<0.01)。治疗组术后1、2、3年生存率分别为100%、80.0%和61.8%,对照组则为96.0%、52.5%和35.6%,两组2、3年生存率比较,差异有显著性意义(P<0.01)。结论一次性腹腔温热灌注化疗简便、高效、安全,具有杀灭腹腔游离癌细胞的作用,可降低患者术后腹腔复发率和提高生存率。

Clinical study of intraoperative intraperitoneal hyperthermic chemotherapy for gastric cancer

Objective To investigate the clinical effect and value of intraoperative intraperitoneal hyperthermic chemotherapy in advanced gastric cancer. Methods Fifty five cases in treatment group with advanced gastric cancer received intraoperative intraperitoneal hyperthermic chemotherapy and other 101 cases in control group received only saline water lavage after radical resection. Isolated cancer cells were examined in peritoneal fluid and prognosis was compared between two groups. Results The positive rate of isolated cancer cell in peritoneal fluid was 7.3%in treatment group and 38.6%in the control group (P< 0.01). The peritoneal recurrence rates within two years after operation were 14.5%and 38.6%respectively(P< 0.01), and the 1 , 2 , 3 year survival rates were 100%, 80.0%and 61.8%, and 96.0%, 52.5%and 35.6%respectively in the treatment and control groups. There were significant differences in the 2 ,3 year survival rates between two groups(P< 0.01). Conclusions Intraoperative intraperitoneal hyperthermic chemotherapy can kill isolated intraperitoneal cancer cells, reduce peritoneal recurrence after radical resection, and improve the prognosis. It is a kind of convenient, highly effective, and safe treatment method for advanced gastric cancer, deserving to be popularized.