Kitamura M, Arai K, Iwasaki Y
Dept. of Surgery, Tokyo Metropolitan Komagome Hospital.
Gan To Kagaku Ryoho. 1995 Sep;22(11):1523-6.
A cytological examination in the lavaged peritoneal fluid during operation was performed in 462 patients with gastric cancer. The incidence of positive cytology was 36% in serosal invasion cases. The prognosis of positive cytology cases without peritoneal dissemination was slightly better than the P (+) cases. The incidence of the positive cytology was 48% in patients with serosal invasion more than 16 cm2. The prognosis of patients with serosal invasion below 32 cm2 was significantly better than in the patients with above 32 cm2. Intraperitoneal repeated administration of MMC 10 mg/body and CDDP 40-50 mg/body was continued one a month via the drug delivery system. Negative change of cytology was observed in 7 out of 14 patients, and the prognosis of these patients was better than that of the unchanged cytology group. Side effects such as severe gastrointestinal symptoms and bone marrow toxicities were not observed. Further studies should be done to confirm the efficacy of the intraperitoneal chemotherapy in terms of the prolongation of life.
对462例胃癌患者在手术期间进行了灌洗腹腔液的细胞学检查。在浆膜侵犯病例中，细胞学阳性的发生率为36%。无腹膜播散的细胞学阳性病例的预后略好于P(+)病例。浆膜侵犯面积超过16 cm²的患者中，细胞学阳性的发生率为48%。浆膜侵犯面积低于32 cm²的患者的预后明显好于超过32 cm²的患者。通过给药系统每月一次持续腹腔内重复给予丝裂霉素10 mg/体和顺铂40 - 50 mg/体。14例患者中有7例观察到细胞学转阴，这些患者的预后好于细胞学未改变的组。未观察到严重胃肠道症状和骨髓毒性等副作用。应进一步开展研究以证实腹腔内化疗在延长生存期方面的疗效。
