CAJ | 학술논문

目的探讨局部进展期胃癌术前全身静脉联合区域动脉灌注化疗栓塞的有效性和安全性.方法分析郑州大学第一附属医院胃肠外科自2008年1月至2012年7月收治的158例接受新辅助治疗后行手术切除的局部进展期胃癌患者的临床资料,其中术前全身静脉联合区域动脉灌注化疗栓塞者78例(A组),术前全身静脉化疗者80例(B组),休息3～4周后手术.比较两组术后组织病理学疗效、化疗毒性反应发生率及术后并发症发生率.结果两组术后标本的组织病理学评估均有效,A组和B组的疗效满意率分别是60％和42％,差异有统计学意义(X2 =6.136,P＜0.05)；A组化疗毒性反应(除外恶心反应)和术后吻合口瘘、肠梗阻、切口愈合不良、腹腔感染及肺部感染等并发症发生率均低于B组(均P＜0.05),而恶心反应发生率高于B组(x2=16.458,P＜0.01)；两组均无新辅助治疗相关死亡病例.结论局部进展期胃癌术前全身静脉联合区域动脉灌注化疗并栓塞的疗效确切,可降低化疗毒性反应,并且不增加术后并发症的发生率.
목적 탐토국부진전기위암술전전신정맥연합구역동맥관주화료전새적유효성화안전성.방법 분석정주대학제일부속의원위장외과자2008년1월지2012년7월수치적158례접수신보조치료후행수술절제적국부진전기위암환자적림상자료,기중술전전신정맥연합구역동맥관주화료전새자78례(A조),술전전신정맥화료자80례(B조),휴식3～4주후수술.비교량조술후조직병이학료효、화료독성반응발생솔급술후병발증발생솔.결과 량조술후표본적조직병이학평고균유효,A조화B조적료효만의솔분별시60％화42％,차이유통계학의의(X2 =6.136,P＜0.05)；A조화료독성반응(제외악심반응)화술후문합구루、장경조、절구유합불량、복강감염급폐부감염등병발증발생솔균저우B조(균P＜0.05),이악심반응발생솔고우B조(x2=16.458,P＜0.01)；량조균무신보조치료상관사망병례.결론 국부진전기위암술전전신정맥연합구역동맥관주화료병전새적료효학절,가강저화료독성반응,병차불증가술후병발증적발생솔.
Objective To investigate the efficacy and safety of preoperative systemic chemotherapy combined with regional intraarterial chemoembolization in the treatment of locally advanced gastric cancer.Methods Clinical data of 158 patients of locally advanced gastric receiving neoadjuvant chemotherapy cancer from January 2008 to July 2012 were retrospectively analyzed.Patients were divided into two groups:those who received preoperative systemic chemotherapy plus regional intraarterial chemoembolization (group A,n =78) and those who received preoperative systemic chemotherapy (group B,n =80).Radical resection was perfomed after 3 to 4 weeks.Results The overall satisfactory rate was significantly higher (60％) in group A compared with 42％ in group B (x2 =6.136,P ＜0.05).The incidence rate of toxicity reaction (except nausea) and postoperative conplications such as anastomotic leakage,intestinal obstruction,poor wound healing,abdominal infection and pulmonary infection were all lower in group A than in group B (all P ＜ 0.05),while the incidence rate of nausea was higher in group A than in Group B (x2 =16.458,P ＜ 0.01).There was no perioperative mortality related to neoadjuvant therapy in two groups.Conclusions Preoperative systemic chemotherapy combined with regional intraarterial chemoembolization was associated with better efficacy,and fewer toxicity reactions and postoperative complications in the treatment of locally advanced gastric cancer.