CAJ | 학술논문

腹膜肿瘤播散是进展期胃癌转移或胃癌根治术后复发最常见的类型，患者一旦出现腹膜转移复发的临床症状，其中位数生存期仅约4~6个月，预后极差。既往，一些辅助性化疗方案虽能改善患者的预后，但由于“血浆-腹膜屏障”作用，全身性化疗对于腹膜转移复发收效甚微。有鉴于此，近年来临床上应用全身性与腹腔内联合新辅助化疗﹙NIPS)治疗胃癌腹膜转移，取得了较好的效果。静脉内与腹腔内给以紫杉醇，并口服替吉奥﹙S-1)的联合化疗方案经过药动学与药效学研究，业已证实对患者有较好的耐受性，并在预防与治疗胃癌腹膜转移过程中取得较好的临床效果。本文中，作者对联合紫杉醇与S-1治疗胃癌腹膜转移的疗效作了较系统的介绍。
복막종류파산시진전기위암전이혹위암근치술후복발최상견적류형，환자일단출현복막전이복발적림상증상，기중위수생존기부약4~6개월，예후겁차。기왕，일사보조성화료방안수능개선환자적예후，단유우“혈장-복막병장”작용，전신성화료대우복막전이복발수효심미。유감우차，근년래림상상응용전신성여복강내연합신보조화료﹙NIPS)치료위암복막전이，취득료교호적효과。정맥내여복강내급이자삼순，병구복체길오﹙S-1)적연합화료방안경과약동학여약효학연구，업이증실대환자유교호적내수성，병재예방여치료위암복막전이과정중취득교호적림상효과。본문중，작자대연합자삼순여S-1치료위암복막전이적료효작료교계통적개소。
[Abstract ] Peritoneal dissemination is the most common metastasis form in patients with highly advanced gastric cancer ﹙AGC) or with recurrence after radical gastrectomy. The median survival time after manifestation of peritoneal carcinomatosis is about 4-6 months. Most systemic chemotherapeutic agents are not effective for peritoneal metastasis because of the blood-peritoneum barrier, although some adjuvant chemotherapy definitely improves overall survival. In this regard, neoadjuvant intraperitoneal-systemic chemotherapy ﹙NIPS) has been recently considered as an additional adjuvant therapy for AGC with peritoneal metastasis. Combined chemotherapy of intravenous and intraperitoneal paclitaxel with oral S-1 has been confirmed by pharmacokinetic and pharmacodynamic studies to be well tolerated and well effective in gastric cancer patients with peritoneal metastasis. In this article, authors make a comprehensive introduction to clinical efficacy by adopting paclitaxel and S-1 to gastric cancer patients with peritoneal metastasis.