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目的:观察细胞减灭术加腹腔热灌注化疗(CRS+HIPEC)联合靶向新药PDOX治疗胃癌腹膜癌(PC)的疗效和安全性。方法:将VX2瘤细胞注入40只新西兰兔胃窦部黏膜下,制成胃癌PC模型,随机分4组(n=10):Control组观察自然病程;HIPEC组行CRS+HIPEC;PDOX组和DOX组行CRS+HIPEC联合化疗(PDOX 50.0 mg/kg,DOX 5.0 mg/kg)。结果:模型成功率100%(40/40)。Control组中位生存期23.0 d(95%CI:19.9～26.1 d),HIPEC组41.0(36.9～45.1)d,PDOX组58.0(39.6～54.4)d,DOX组65.0(44.1～71.9)d。HIPEC组生存期较Control组延长70.0%以上(P<0.001),PDOX组和DOX组较HIPEC组延长40.0%以上(P=0.029、P=0.021)。DOX组化疗后WBC、PLT低于HIPEC组(P<0.05),各组间血液学指标差异无统计学意义(P>0.05)。结论:在CRS+HIPEC基础上,联合靶向新药PDOX可进一步延长胃癌PC模型生存期,毒性无明显增加。
Objective: To observe the efficacy and safety of cytoreductive surgery combined with intraperitoneal hyperthermic perfusion (CRS + HIPEC) combined with targeted PDOX in the treatment of gastric cancer with peritoneal carcinoma (PC). Methods: VX2 tumor cells were infused into the mucosa of 40 antral mucosa of New Zealand rabbits to make PC model of gastric cancer. The rats were randomly divided into 4 groups (n = 10): control group observed the natural course of disease; HIPEC group performed CRS + HIPEC; PDOX group and DOX Group CRS + HIPEC combined with chemotherapy (PDOX 50.0 mg / kg, DOX 5.0 mg / kg). Results: The model success rate was 100% (40/40). The median survival time in Control group was 23.0 d (95% CI: 19.9-26.1 d), 41.0 (36.9-45.1) d in HIPEC group, 58.0 (39.6-54.4) d in PDOX group and 65.0 (44.1-71.9) d in DOX group. The survival of HIPEC group was prolonged by 70.0% or more than that of Control group (P <0.001). The PDOX group and DOX group were longer than HIPEC group by 40.0% (P = 0.029, P = 0.021). The WBC and PLT in DOX group were lower than that in HIPEC group (P <0.05), but there was no significant difference between the two groups in hematological parameters (P> 0.05). Conclusion: Combined targeting of PDOX and CRS + HIPEC could prolong the survival of PC model of gastric cancer without any significant increase in toxicity.