论文部分内容阅读
目的：通过动物实验及临床应用，证实活性碳吸附丝裂霉素C腹腔化疗能治疗和预防进展期胃癌术后腹腔复发，从而提高患者的生存率。方法：利用人胃癌裸鼠模型进行活性碳（CH）吸附MMC腹腔化疗的动物实验，共分4组，每组8只荷瘤裸鼠。实验组腹腔给予CH－MMC，腹腔化疗组腹腔给予MMC，静脉化疗组经内眦静脉给予MMC，对照组腹腔注入等容量生理盐水。临床应用时将可以根治手术的64例进展期T3~4NxM0）胃癌病例随机分为2组，实验组于手术结束时腹腔内给予经医用活性碳吸附的MMC 50mg，术后3个月开始常规静脉化疗。对照组仅于手术后3周开始静脉化疗。结果：动物试验结果表明实验组疗效最佳，仅于2只小鼠腹腔发现较小（1~3mm）的转移灶；单纯腹腔化疗组中，有3只小鼠腹腔出现较广泛的转移灶，直径在3~15mm之间；静脉化疗组中6只小鼠腹腔出现广泛转移病灶；对照组8只小鼠腹腔均发生广泛转移瘤。经过平均15．4个月2~36个月的随访，临床应用实验组较对照组2、3年生存率分别提高42．03％及53．44％（76．27％76．27％和34．24％22．83％，P＜ 0．05。结论：活性碳吸附MMC腹腔化疗确能提高进展期胃癌根治性手术后无瘤生存率。
OBJECTIVE: Through animal experiments and clinical application, it was confirmed that intraperitoneal chemotherapy with activated carbon-adsorbed mitomycin C can treat and prevent post-operative intra-abdominal recurrence of advanced gastric cancer, thereby improving the patient’s survival rate. METHODS: Animal experiments were conducted using human gastric cancer nude mice model for intraperitoneal chemotherapy with activated carbon (CH) adsorbed on MMCs. They were divided into 4 groups. Each group contained 8 tumor-bearing nude mice. The experimental group received intraperitoneal administration of CH-MMC. The intraperitoneal chemotherapy group received intraperitoneal administration of MMC. In the intravenous chemotherapy group, MMC was administered via the internal iliac vein, and the control group was intraperitoneally injected with equal volume of saline. In the clinical application, 64 cases of advanced gastric cancer with advanced T3~4NxM0) gastric cancer were randomly divided into 2 groups. At the end of the operation, the experimental group received intraperitoneal administration of 50 mg of MMC adsorbed on activated carbon, and began routinely 3 months after surgery. Intravenous chemotherapy. The control group only started intravenous chemotherapy 3 weeks after surgery. RESULTS: The results of animal experiments showed that the experimental group had the best curative effect. Only a small (1-3 mm) metastasis was found in the abdomen of 2 mice. In the simple intraperitoneal chemotherapy group, 3 mice had more extensive metastasis in the abdominal cavity. Diameters ranged from 3 to 15 mm; 6 mice in the intravenous chemotherapy group had extensive metastatic lesions in the abdominal cavity; 8 mice in the control group developed extensive metastases in the abdominal cavity. After an average of 15.4 months and 2 to 36 months of follow-up, the 2-year survival rate in the clinically applied experimental group was 42.03% and 53.44% higher than that in the control group (76.27%/76.27, respectively). % and 34.24% 22.83% ,, P < 0.05.Conclusion: Activated carbon adsorption MMC intraperitoneal chemotherapy can improve the disease-free survival rate of advanced gastric cancer after radical surgery.