疑难病杂志
疑難病雜誌
의난병잡지
Chinese Journal of Difficult and Complicated Cases
2015年
10期
1043-1046
,共4页
胃癌根治术%腹腔热灌注化疗%XELOX化疗方案%肿瘤标志物%复发率%生存率
胃癌根治術%腹腔熱灌註化療%XELOX化療方案%腫瘤標誌物%複髮率%生存率
위암근치술%복강열관주화료%XELOX화료방안%종류표지물%복발솔%생존솔
Gastrectomy%Peritoneal perfusion chemotherapy%XELOX regimen%Tumor markers%Recurrence rate%Survival rate
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%)(χ2=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(χ2=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%(χ2=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。
目的:觀察胃癌根治術後腹腔熱灌註化療聯閤奧沙利鉑(OXA)+卡培他濱(Xeloda)(XELOX方案)輔助化療的臨床療效與安全性。方法2011年1月—2012年3月收治胃癌術後患者112例,按術後治療方法分為觀察組(54例)和對照組(58例),觀察組術後給予腹腔熱灌註化療(順鉑+5-氟尿嘧啶)2~3次,2週後予XELOX 4週期化療方案;對照組術後僅予XELOX 4週期化療方案。比較2組化療期間藥物毒性反應,化療結束後30 d採血檢測腫瘤標誌物[癌胚抗原(CEA)、糖蛋白抗原19-9(CA19-9)]水平,隨訪觀察患者複髮率、轉移率與3年生存率。結果觀察組化療後30 d CEA水平為(4÷.2±2.0)μg/L,CA19-9水平為(19.7±6.5) U/ml,對照組分彆為(7.1±3.1)μg/L、(37.4±15.1) U/ml,均顯著低于治療前( P <0.01),且治療後觀察組水平明顯低于對照組( U =5.923、8.153, P <0.01)。觀察組特異性毒性反應主要為腹膜刺激癥狀40例(18.5%),明顯高于對照組的2例(3.4%)(χ2=6.639, P =0.010),其餘藥物毒性反應髮生率差異無統計學意義( P >0.05)。觀察組隨訪期內複髮率為13.5%、遠處轉移率為19.3%,均低于對照組的32.1%、30.4%,其中複髮率差異有統計學意義(χ2=5.267, P =0.022)。觀察組3年生存率為77.8%,明顯高于對照組的58.6%(χ2=4.705, P =0.030)。結論胃癌根治術後在行XELOX方案輔助化療基礎上,聯閤行腹腔熱灌註化療能進一步殺滅脫落癌細胞,降低腫瘤複髮與遠處轉移率,延長遠期生存時間,不良反應輕微可控。
목적:관찰위암근치술후복강열관주화료연합오사리박(OXA)+잡배타빈(Xeloda)(XELOX방안)보조화료적림상료효여안전성。방법2011년1월—2012년3월수치위암술후환자112례,안술후치료방법분위관찰조(54례)화대조조(58례),관찰조술후급여복강열관주화료(순박+5-불뇨밀정)2~3차,2주후여XELOX 4주기화료방안;대조조술후부여XELOX 4주기화료방안。비교2조화료기간약물독성반응,화료결속후30 d채혈검측종류표지물[암배항원(CEA)、당단백항원19-9(CA19-9)]수평,수방관찰환자복발솔、전이솔여3년생존솔。결과관찰조화료후30 d CEA수평위(4÷.2±2.0)μg/L,CA19-9수평위(19.7±6.5) U/ml,대조조분별위(7.1±3.1)μg/L、(37.4±15.1) U/ml,균현저저우치료전( P <0.01),차치료후관찰조수평명현저우대조조( U =5.923、8.153, P <0.01)。관찰조특이성독성반응주요위복막자격증상40례(18.5%),명현고우대조조적2례(3.4%)(χ2=6.639, P =0.010),기여약물독성반응발생솔차이무통계학의의( P >0.05)。관찰조수방기내복발솔위13.5%、원처전이솔위19.3%,균저우대조조적32.1%、30.4%,기중복발솔차이유통계학의의(χ2=5.267, P =0.022)。관찰조3년생존솔위77.8%,명현고우대조조적58.6%(χ2=4.705, P =0.030)。결론위암근치술후재행XELOX방안보조화료기출상,연합행복강열관주화료능진일보살멸탈락암세포,강저종류복발여원처전이솔,연장원기생존시간,불량반응경미가공。
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 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 .