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目的 探讨进展期胃癌术后行腹腔持续温热灌注联合静脉的双途径化疗的临床疗效。方法 82例Ⅱ～Ⅳ期胃癌术后患者随机分为治疗组和对照组。治疗组 4 6例 ,腹腔持续温热灌注联合静脉的双途径化疗 3次 ,常规静脉化疗 3次 ;对照组 36例 ,常规静脉化疗 6次。两组化疗均采用LFAP方案 (甲酰四氢叶酸钙 +5 氟脲嘧啶 +吡喃阿霉素或米托蒽醌 +顺铂 ) ,并均于术后 2 1～ 2 8d开始化疗。结果 治疗组 1,3年生存率分别为 97.8% (45 / 4 6 )和 82 .6 % (38/ 4 6 ) ,对照组分别为 94 .4 %(34/ 36 )和 6 1.1% (2 2 / 36 )。两组 1年生存率差异无显著性 (P >0 .0 5 ) ,3年生存率差异有显著性 (P <0 .0 5 )。治疗组和对照组Ⅱ度以上胃肠道反应发生率分别为 37.0 %和 80 .6 % ,差异有显著性 (P <0 .0 1) ;两组骨髓抑制差异无显著性 (P >0 .0 5 )。结论 双途径化疗可延长Ⅱ～Ⅳ期胃癌术后患者的生存期 ,降低Ⅱ度以上胃肠道反应发生率。
Objective To investigate the clinical efficacy of dual-path chemotherapy with continuous peritoneal warm perfusion combined with intravenous chemotherapy after advanced gastric cancer. Methods 82 cases of stage Ⅱ ~ Ⅳ gastric cancer patients were randomly divided into treatment group and control group. In the treatment group, 46 cases were treated with intraperitoneal warm infusion and venous double-channel chemotherapy three times, routine intravenous chemotherapy three times, control group 36 cases and routine intravenous chemotherapy 6 times. LFAP regimen (calcium leucovorin + 5-fluorouracil + pirarubicin or mitoxantrone + cisplatin) was used in both groups, and chemotherapy was started 21 to 28 days after operation. Results The 1-year and 3-year survival rates were 97.8% (45/46) and 82.6% (38/46) in the treatment group and 94.4% (34/36) and 61.1% (2) in the control group 2/36). There was no significant difference in one-year survival rate between the two groups (P> 0.05), and the difference of three-year survival rate was significant (P <0.05). The incidences of gastrointestinal reactions above grade Ⅱ in treatment group and control group were 37.0% and 80.6%, respectively, with significant difference (P <0.01). There was no significant difference in bone marrow suppression between the two groups (P> 0.05). 0 5). Conclusion Dual-route chemotherapy can prolong the survival of patients with stage II-IV gastric cancer and reduce the incidence of gastrointestinal reactions of more than grade II.