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目的 :研究腹腔免疫化疗在胃肠道癌术后对早期腹腔局部复发和肝转移的疗效。方法 :1995年 1月 - 1997年 12月对 198例行根治性手术治疗的胃肠道癌病人按年限分成腹腔化疗组 12 2例 (1995年 1月 - 1996年 12月 )和腹腔免疫化疗组 76例 (1997年 1月 - 1997年 12月 )。腹腔化疗组于术后第 7天行腹腔化疗 ,化疗方案为FDM方案 ,每 5d为 1个疗程 ,每 4周 1个疗程 ,连续 6个疗程 ,每 3个月 1个疗程 ,至术后 2a。腹腔免疫化疗组采用FDM +IFNα - 2b方案 ,药量及液体量同腹腔化疗组。结果 :胃肠道癌根治性切除术后腹腔免疫化疗组与腹腔化疗组相比 ,术后早期局部复发率 (4/ 76 ) ,χ2 =6 .42 ,P <0 .0 1,肝转移率 (2 / 76 ) ,χ2 =7.2 2 ,P <0 .0 1。 3a生存率(6 8%、5 0 % ) ,χ2 =12 .80 ,P <0 .0 1。 3a以上无瘤存活例数分别为 40例及 32例 ,χ2 =5 .5 6 ,P <0 .0 5。结论 :胃肠道癌根治性术后腹腔免疫化疗可显著降低早期局部复发及肝转移 ,近期疗效和 3a生存率明显优于腹腔化疗。
Objective: To study the effect of intraperitoneal immunotherapy on early peritoneal local recurrence and liver metastasis after gastrointestinal cancer. METHODS: From January 1995 to December 1997, 198 patients with gastrointestinal cancer who underwent radical surgery were divided into 12 patients (period from January 1995 to December 1996) and peritoneal immunotherapy group. 76 cases (January 1997 - December 1997). The intraperitoneal chemotherapy group received intraperitoneal chemotherapy on the seventh day postoperatively. The chemotherapy regimen was FDM regimen. Each 5 days was a course of treatment, every 4 weeks, 1 course of treatment, 6 consecutive courses of treatment, 1 course of treatment every 3 months, and postoperative 2a. . In the intraperitoneal immunotherapy group, the FDM + IFNα-2b regimen was used. The dose and fluid volume were the same as the intraperitoneal chemotherapy group. RESULTS: After radical resection of gastrointestinal cancer, there was a local recurrence rate (4/76) in the early postoperative peritoneal immunotherapy group compared with the intraperitoneal chemotherapy group, χ2 = 6.42, P < 0.01, liver metastasis rate. (2 / 76), χ 2 = 7.2 2, P <0. 0 1. The 3a survival rate (6 8%, 50%), χ 2 =12.80, P <0. The number of tumor-free survivors above 3a was 40 and 32, respectively, χ2=5.56, P<0.05. Conclusion : Gastrointestinal cancer after radical mastectomy can significantly reduce early local recurrence and liver metastasis. The short-term efficacy and 3-year survival rate are significantly better than that of intraperitoneal chemotherapy.