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[热灌注术中腹腔内化疗在胃癌患者中的应用]

[Application of hyperthermic intraoperative intraperitoneal chemotherapy in patients with gastric cancer].

作者信息

Zhang Gui-ying, Chen Xiao-chun, Pan Kai, Xia Li-gang, Zuo Min, Zheng Tao

机构信息

Department of General Surgery, Shenzhen People's Hospital, Shenzhen 518020, China.

出版信息

Zhonghua Wei Chang Wai Ke Za Zhi. 2007 Jul;10(4):362-4.

Abstract

OBJECTIVE

To explore the effect of hyperthermic intraoperative intraperitoneal chemotherapy (HIIC) on the postoperative metastatic rate and survival rate of advanced gastric cancer (AGC).

METHODS

In HIIC group, patients received HIIC (mitomycin C 30 mg and cisplatin 100 mg were added into 2000 ml distilled water, heated to 42 approximately 45 degrees C, perfused to abdominal cavity for 30 min and then sucked) and intravenous chemotherapy after operation (5- FU 10 approximately 15 mg/kg, mitomycin C 0.1 approximately 0.15 mg/kg, adriamycin 0.5 approximately 1 mg/kg i.v drip, once a week for 2 approximately 3 weeks). In control group, patients received intravenous chemotherapy only. The postoperative metastatic rate and survival rate (1- , 3- and 5- year) of patients were compared between 92 cases of AGC undergone HIIC and 120 cases of AGC without HIIC (control group).

RESULTS

The peritoneal recurrence rates after operations occurred within two years were 14.1% and 37.5% in HIIC group and control group respectively (P < 0.01). The 1- , 3- , and 5- year survival rates in HIIC group were 98.9%, 68.5%, and 52.2% and in control group 95.0%, 56.7% and 37.5% respectively. The 3- , and 5- year survival rates were significantly different between the two the groups (P < 0.05).

CONCLUSION

HIIC can kill isolated intraperitoneal cancer cells, reduce peritoneal recurrence rate after operations, raise significantly survival rate of patient, and improve the prognosis of AGC.

摘要

目的

探讨术中腹腔内热灌注化疗(HIIC)对进展期胃癌(AGC)术后转移率及生存率的影响。

方法

HIIC组患者接受HIIC(将丝裂霉素C 30mg和顺铂100mg加入2000ml蒸馏水中,加热至42~45℃,灌注至腹腔30分钟后吸出)及术后静脉化疗(5-氟尿嘧啶10~15mg/kg、丝裂霉素C 0.1~0.15mg/kg、阿霉素0.5~1mg/kg静脉滴注,每周1次,共2~3周)。对照组患者仅接受静脉化疗。比较92例接受HIIC的AGC患者和120例未接受HIIC的AGC患者(对照组)的术后转移率及生存率(1年、3年和5年)。

结果

HIIC组和对照组术后两年内的腹膜复发率分别为14.1%和37.5%(P<0.01)。HIIC组的1年、3年和5年生存率分别为98.9%、68.5%和52.2%,对照组分别为95.0%、56.7%和37.5%。两组的3年和5年生存率有显著差异(P<0.05)。

结论

HIIC可杀灭腹腔内孤立癌细胞,降低术后腹膜复发率,显著提高患者生存率,改善AGC的预后。

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