摘要
目的观察胃癌根治术后腹腔热灌注化疗联合奥沙利铂(OXA)+卡培他滨(Xeloda)(XELOX方案)辅助化疗的临床疗效与安全性。方法 2011年1月—2012年3月收治胃癌术后患者112例,按术后治疗方法分为观察组(54例)和对照组(58例),观察组术后给予腹腔热灌注化疗(顺铂+5-氟尿嘧啶)2~3次,2周后予XELOX 4周期化疗方案;对照组术后仅予XELOX 4周期化疗方案。比较2组化疗期间药物毒性反应,化疗结束后30 d采血检测肿瘤标志物[癌胚抗原(CEA)、糖蛋白抗原19-9(CA19-9)]水平,随访观察患者复发率、转移率与3年生存率。结果观察组化疗后30 d CEA水平为(4.2±2.0)μg/L,CA19-9水平为(19.7±6.5)U/ml,对照组分别为(7.1±3.1)μg/L、(37.4±15.1)U/ml,均显著低于治疗前(P<0.01),且治疗后观察组水平明显低于对照组(U=5.923、8.153,P<0.01)。观察组特异性毒性反应主要为腹膜刺激症状40例(18.5%),明显高于对照组的2例(3.4%)(x^2=6.639,P=0.010),其余药物毒性反应发生率差异无统计学意义(P>0.05)。观察组随访期内复发率为13.5%、远处转移率为19.3%,均低于对照组的32.1%、30.4%,其中复发率差异有统计学意义(x^2=5.267,P=0.022)。观察组3年生存率为77.8%,明显高于对照组的58.6%(x^2=4.705,P=0.030)。结论胃癌根治术后在行XELOX方案辅助化疗基础上,联合行腹腔热灌注化疗能进一步杀灭脱落癌细胞,降低肿瘤复发与远处转移率,延长远期生存时间,不良反应轻微可控。
Objective To observe the clinical efficacy and safety of the gastric cancer radical postoperative intraperi toneal hyperthermic perfusion chemotherapy combined with oxaliplatin （OXA） ＋capecitabine （Xeloda） （XELOX regimen） adjuvant chemotherapy .Methods From 2011 January to 2012 March, 112 cases gastric cancer patients were enrolled , ac-cording to the method of postoperative treatment , they were divided into observation group （54 cases） and control group （58 cases）.Patients in the observation group were given chemotherapy of intraperitoneal hyperthermic perfusion chemotherapy （cisplatin ＋fluorouracil） 2-3 times, 2 weeks later were given XELOX for 4 cycles of chemotherapy;after surgery, in the control group , patients only received XELOX for 4 cycles of chemotherapy .Compared chemotherapy drug toxicity of the 2 group, after 30 days of chemotherapy , blood samples were collected to detect tumor marker [ carcinoembryonic antigen （CEA）, carbohydrate antigen 199 （CA19-9）] level.All the patients were followed up to observe the recurrence rate , metas-tasis rate and 3 years survival rate .Results In the observation group after chemotherapy , after 30 days ’ CEA levels was （4.2 ±2.0）μg/L, CA19-9 level was （19.7 ±6.5） U /ml.The control group were （7.1 ±3.1）μg/L, （37.4 ±15.1） U/ml respectively, all were significantly lower than before treatment （ P 〈0.01）, and observation group was significantly lower than that of the control group （ U =5.923, U =8.153, P 〈0.01）.Observation group’s specific toxicity mainly was perito-neal irritation symptoms with 40 cases （18.5%）, which was significantly higher than that of control group ’s 2 cases （3.4%） （χ2 =6.639, P =0.010）, the rest of the drug toxicity showed no statistical significance differences （ P 〉0.05）.Observa-tion group’s rate of recurrence during the follow-up period was 13.5%, metastasis rate was 19.3%, which were lower than the control group’s 32.1%and 30.4%.The difference of the recurrence rate was statistically significant （χ2 =5.267, P =0.022）.The observation group’s 3 years survival rate was 77.8%, which was significantly higher than the control group ’s 58.6%（χ2 =4.705, P =0.030）.Conclusion After radical gastrectomy for gastric cancer , combined with XELOX regimen＆amp;nbsp;adjuvant chemotherapy and intraperitoneal perfusion chemotherapy can further kill off cancer cells , reduce tumor recurrence and metastasis rate , prolong the long-term survival time , adverse reactions are mild and controllable .
出处
《疑难病杂志》
CAS
2015年第10期1043-1046,共4页
Chinese Journal of Difficult and Complicated Cases
