Markelis Rytis, Endzinas Zilvinas, Grižas Saulius, Pundzius Juozas, Saladžinskas Zilvinas, Juozaitytė Elona, Inčiūra Arturas, Pranys Darius, Maleckas Almantas
Department of Surgery, Medical Academy, Lithuanian University of Health Sciences, Lithuania.
Medicina (Kaunas). 2011;47(1):63-9.
Surgery remains the main treatment modality for gastric cancer. Adjuvant radiochemotherapy and adjuvant chemotherapy are becoming more and more popular in the treatment of advanced gastric cancer. Early postoperative intraperitoneal chemotherapy as one of the methods of adjuvant chemotherapy is currently being extensively investigated. The aim of the present study was to evaluate the toxicity of early postoperative intraperitoneal chemotherapy and its impact on postoperative complications as well as long-term survival.
A prospective study including 46 patients with gastric cancer who underwent radical resection was carried out during 2004-2005. Fourteen patients who received early postoperative intraperitoneal chemotherapy with 5-FU (EPIC group) were compared with 32 patients not receiving intraperitoneal chemotherapy (control group). All patient, except one patient in the EPIC group, received adjuvant radiochemotherapy or adjuvant chemotherapy. The toxicity of early postoperative intraperitoneal chemotherapy was evaluated using the WHO scale, and survival was estimated by the Kaplan-Meier method.
The rate of postoperative complications was similar in both the groups (14.3% in the EPIC group vs. 12.5% in the control group). Four patients (28.6%) in the EPIC group developed grade III toxicity. There was no difference in survival comparing the EPIC group with the control group (median survival, 30 months and 34 months, respectively; P=0.500).
Early postoperative intraperitoneal chemotherapy with 5-fluorouracile demonstrated acceptable toxicity and was relatively simple to perform. No survival benefit was documented combining early postoperative intraperitoneal chemotherapy with adjuvant radiochemotherapy or adjuvant chemotherapy.
手术仍然是胃癌的主要治疗方式。辅助放化疗和辅助化疗在晚期胃癌的治疗中越来越普遍。术后早期腹腔内化疗作为辅助化疗方法之一，目前正在广泛研究中。本研究的目的是评估术后早期腹腔内化疗的毒性及其对术后并发症和长期生存的影响。
2004年至2005年期间对46例行根治性切除术的胃癌患者进行了一项前瞻性研究。将14例接受5-氟尿嘧啶术后早期腹腔内化疗的患者（EPIC组）与32例未接受腹腔内化疗的患者（对照组）进行比较。除EPIC组的1例患者外，所有患者均接受了辅助放化疗或辅助化疗。使用WHO标准评估术后早期腹腔内化疗的毒性，并采用Kaplan-Meier法估计生存率。
两组术后并发症发生率相似（EPIC组为14.3%，对照组为12.5%）。EPIC组有4例患者（28.6%）发生Ⅲ级毒性。EPIC组与对照组的生存率无差异（中位生存期分别为30个月和34个月；P = 0.500）。
5-氟尿嘧啶术后早期腹腔内化疗显示出可接受的毒性，且操作相对简单。术后早期腹腔内化疗联合辅助放化疗或辅助化疗未显示出生存获益。
