CAJ | 학술논문

目的观察热疗联合化疗治疗晚期胃癌的临床疗效.方法采用随机数字表法将89例晚期胃癌患者分为研究组及对照组.研究组患者给予热疗及化疗联合干预,对照组患者则单纯给予化疗.化疗选用CapeOx(卡培他滨+奥沙利铂)方案:第1天给予奥沙利铂(130 mg/m2)静滴,第1 ～14天给予卡培他滨(1000 mg/m2)口服(2次/d),治疗21d为1个周期.研究组于上述化疗第1天即进行热疗,使肿瘤部位温度稳定在43℃,每次治疗持续60 min,以后每周热疗2次,治疗21 d为1个周期.经连续治疗2个周期后对2组患者肿瘤疗效进行评定；采用卡式功能状态评分(KPS)评定2组患者生活质量,同时观察并记录2组患者治疗期间毒副反应发生情况.结果研究组及对照组治疗有效率分别为68.9％和36.4％,组间差异具有统计学意义(P＜0.05)；两组中位无进展生存期分别为8.3个月和5.2个月,1年生存率分别为64.4％和45.5％,卡氏评分提高率分别为77.8％和45.5％,上述指标组间差异均具有统计学意义(均P＜O.05).两组患者常见毒副反应包括胃肠道毒性、骨髓抑制及周围神经异常等,但患者均可耐受,对日常治疗未造成影响.结论内生场热疗联合CapeOx方案治疗晚期胃癌患者具有增效作用,可提高患者近期疗效,延缓疾病进展,进一步改善患者生活质量,该联合疗法值得临床推广、应用.
목적 관찰열료연합화료치료만기위암적림상료효.방법 채용수궤수자표법장89례만기위암환자분위연구조급대조조.연구조환자급여열료급화료연합간예,대조조환자칙단순급여화료.화료선용CapeOx(잡배타빈+오사리박)방안:제1천급여오사리박(130 mg/m2)정적,제1 ～14천급여잡배타빈(1000 mg/m2)구복(2차/d),치료21d위1개주기.연구조우상술화료제1천즉진행열료,사종류부위온도은정재43℃,매차치료지속60 min,이후매주열료2차,치료21 d위1개주기.경련속치료2개주기후대2조환자종류료효진행평정；채용잡식공능상태평분(KPS)평정2조환자생활질량,동시관찰병기록2조환자치료기간독부반응발생정황.결과 연구조급대조조치료유효솔분별위68.9％화36.4％,조간차이구유통계학의의(P＜0.05)；량조중위무진전생존기분별위8.3개월화5.2개월,1년생존솔분별위64.4％화45.5％,잡씨평분제고솔분별위77.8％화45.5％,상술지표조간차이균구유통계학의의(균P＜O.05).량조환자상견독부반응포괄위장도독성、골수억제급주위신경이상등,단환자균가내수,대일상치료미조성영향.결론 내생장열료연합CapeOx방안치료만기위암환자구유증효작용,가제고환자근기료효,연완질병진전,진일보개선환자생활질량,해연합요법치득림상추엄、응용.
Objective To explore the synergistic effectiveness of hyperthermia and chemotherapy in the treatment of advanced gastric cancer.Methods Eighty-nine patients with advanced gastric cancer were randomly assigned to a study group which received a CapeOx chemotherapy regimen supplemented with hyperthermia or to a control group which received only the CapeOx regimen.The regimen consisted of capecitabine (1000 mg/m2,bid,orally for 14 consecutive days) plus oxalipaltin (130 mg/m2) on day 1.The hyperthermia was at 43℃ for 60 min in the tumor area on day 1 and twice a week thereafter.One cycle was 21 days.After 2 treatment cycles,efficacy was evaluated according to RECIST standards,improvements in the quality of life were assessed according to Karnofsky's performance status (KPS) and the side-effects of therapy were recorded.Results The response rate was 68.9％ in the study group and 36.4％ in the control group,showing a significant difference between the groups after two treatment cycles.The median progress-free survival (PFS) was 8.3 months in the study group vs 5.2 months for the controls.The 1-year survival rate was 66.4％ vs 45.5％ and the rate of improvement in KPS was 77.8％ vs 45.5％.All these differences were statistically significant.The common adverse effects were gastrointestinal toxicity,marrow depression and peripheral nerve abnormalities,but these adverse effects were all mild and similar in the two groups.Conclusion Hyperthermia when combined with the CapeOx chemotherapy regimen might improve the therapeutic effect in advanced gastric cancer without obviously increasing the adverse effects.