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[顺铂腹腔内温热灌注化疗治疗胃癌肝转移病例]

[CDDP-ip PMUE therapy in gastric cancer cases with liver metastasis].

作者信息

Hasegawa Y, Honnma S, Takanashi K, Yajima K, Nakashima Y

机构信息

Dept. of Surgery, Honnma Hospital.

出版信息

Gan To Kagaku Ryoho. 1991 Aug;18(11):2047-51.

PMID:1908669
Abstract

To reduce liver metastasis and prevent carcinomatous peritonitis, we employed CDDP-ip PMUE therapy in gastric cancer cases with liver metastasis exceeding P0H2S2. Therapy consisted of cis-diammine-dichloroplatinum-ip (CDDP-ip), mitomycin C (MMC), uracil and futraful (UFT) and etoposide. From January 1990 to March 1991, primary lesions were resected in 6 gastric cancer cases with liver metastasis exceeding H2. On the basis of therapy, subjects were classified into 2 groups and the therapeutic effects were compared between them. One group was composed of 3 patients who were placed on CDDP-ip PMUE therapy beginning the 14th day after gastrectomy. The other group was composed of 3 patients who received only UFT oral administration (300 mg/body). As a rule, the following was the CDDP-ip PMUE therapy schedule: CDDP intraperitoneal administration (75 mg/m2) and MMC intravenous injection (10 mg/body) on day 1; etoposide intravenous injection (30 mg/body) on days 2 to 6; and consecutive UFT oral administration (300 mg/body). One case showed MR in a metastatic liver lesion, but treatment proved ineffective in the other cases. Although the 2 patients in the CDDP-ip PMUE therapy group, surviving 315 and 216 days, respectively, died of primary disease and hepatic insufficiency due to an increase in metastatic liver lesions, the third patient has been in good condition for 175 days. This therapy was thought to have prolonged survival. The post-operative survival period in the group of patients receiving only UFT oral administration ranged from 36 to 243 days, with all patients dying of primary disease. The main adverse effects of this therapy (i.e., digestive symptoms, leukopenia, and thrombocytopenia) were slight and transient in all cases. Because the subjects studied were gastric cancer cases exceeding H2, the present investigation resulted in the increase of metastatic liver lesions, a problem to be studied in future.

摘要

为减少肝转移并预防癌性腹膜炎,我们对肝转移超过P0H2S2的胃癌病例采用顺铂腹腔内注射联合PMUE疗法。治疗方案包括顺二氨二氯铂腹腔内注射(CDDP-ip)、丝裂霉素C(MMC)、尿嘧啶和替加氟(UFT)以及依托泊苷。1990年1月至1991年3月,对6例肝转移超过H2的胃癌病例进行了原发灶切除。根据治疗方法,将患者分为2组并比较两组的治疗效果。一组由3例患者组成,在胃切除术后第14天开始接受CDDP-ip PMUE治疗。另一组由3例仅接受UFT口服给药(300mg/人)的患者组成。通常,CDDP-ip PMUE治疗方案如下:第1天腹腔内注射顺铂(75mg/m²)和静脉注射MMC(10mg/人);第2至6天静脉注射依托泊苷(30mg/人);连续口服UFT(300mg/人)。1例患者的转移性肝病灶显示为MR,但其他病例治疗无效。虽然CDDP-ip PMUE治疗组的2例患者分别存活315天和216天,死于原发性疾病和因转移性肝病灶增加导致的肝功能不全,但第3例患者已健康存活175天。该疗法被认为延长了生存期。仅接受UFT口服给药的患者组术后生存期为36至243天,所有患者均死于原发性疾病。该疗法的主要不良反应(即消化道症状、白细胞减少和血小板减少)在所有病例中均轻微且短暂。由于所研究的对象是超过H2的胃癌病例,本研究导致转移性肝病灶增加,这是未来有待研究的问题。

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