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目的探讨胃癌肝转移化疗后进展的介入治疗的临床疗效及安全性。方法 68胃癌肝转移化疗后进展期患者均给予肝动脉灌注化疗为主,结合肝动脉肿瘤血管栓塞的介入治疗的方法。介入用药为阿霉素(ADM)或表阿霉素(EDI)、顺铂(DDP)或卡铂(CBP)、5-氟尿嘧啶(5-FU)等。采用碘化油或超液态碘化油与MMC或ADM混合剂作为栓塞剂,术中适当给予胃复安或枢丹。结果全部患者经治疗后,有效率79.4%。其中,富血供有效率86.7%,少血供有效率77.3%。给予全部患者观察随访3年,死亡11例,患者介入治疗后,平均无进展生存期(FPS)为(5.1±1.1)个月,平均总生存期(OS)为(17.8±2.1)个月。本组患者在治疗过程中,未见严重并发症发生。结论采用介入治疗胃癌肝转移,其临床疗效明确、安全性高,是可靠的治疗方法。
Objective To investigate the clinical efficacy and safety of interventional therapy for progression of gastric cancer after liver metastasis and chemotherapy. Methods 68 patients with advanced gastric cancer after liver metastasis chemotherapy were given mainly hepatic arterial infusion chemotherapy, combined with interventional treatment of hepatic artery tumor embolization. Interventional drugs are doxorubicin (ADM) or epirubicin (EDI), cisplatin (DDP) or carboplatin (CBP), 5-fluorouracil (5-FU) and so on. Iodized oil or super-liquid iodized oil and MMC or ADM mixture as embolization agent, intraoperative given metoclopramide or epididymal. Results All patients after treatment, the effective rate of 79.4%. Among them, rich blood supply efficiency of 86.7%, less blood supply efficiency of 77.3%. All patients were followed up for 3 years and 11 died. After the interventional treatment, the average progression-free survival (FPS) was (5.1 ± 1.1) months and the average overall survival (OS) was (17.8 ± 2.1) months. The patients in the course of treatment, no serious complications occurred. Conclusion Interventional treatment of liver metastasis of gastric cancer has clear clinical efficacy and high safety, which is a reliable treatment.