|本期目录/Table of Contents|

[1]鲍双振,王晓喜,王志超,等.腹腔化疗联合全身化疗对进展期胃癌患者术后复发转移及预后的影响[J].医学研究与战创伤救治(原医学研究生学报),2025,38(01):50-55.[doi:10.16571/j.cnki.2097-2768.2025.01.008]
 BAO Shuangzhen,WANG Xiaoxi,WANG Zhichao,et al.Effect of combined intraperitoneal chemotherapy and systemic chemotherapy on postoperative recurrence,metastasis,and prognosis in patients with advanced gastric cancer[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2025,38(01):50-55.[doi:10.16571/j.cnki.2097-2768.2025.01.008]
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腹腔化疗联合全身化疗对进展期胃癌患者术后复发转移及预后的影响()

《医学研究与战创伤救治》(原医学研究生学报)[ISSN:1672-271X/CN:32-1713/R]

卷:
38卷
期数:
2025年01期
页码:
50-55
栏目:
论著·临床研究
出版日期:
2025-01-20

文章信息/Info

Title:
Effect of combined intraperitoneal chemotherapy and systemic chemotherapy on postoperative recurrence,metastasis,and prognosis in patients with advanced gastric cancer
文章编号:
2097-2768(2025)01-0050-06
作者:
鲍双振王晓喜王志超康政捷刘防震
作者单位:053000 衡水,衡水市人民医院(哈励逊国际和平医院)胃肠外科(鲍双振、王晓喜、康政捷、刘防震);053000 衡水,衡水市第二人民医院肿瘤放疗科(王志超)
Author(s):
BAO ShuangzhenWANG XiaoxiWANG ZhichaoKANG ZhengjieLIU Fangzhen
(1.Department of Gastrointestinal Surgery,Hengshui People’s Hospital,Hengshui 053000,Hebei,China;2.Depart?ment of Tumor Radiotherapy,the Second People’s Hospital of Hengshui,Hengshui 053000,Hebei,China)
关键词:
胃癌腹腔化疗复发转移预后
Keywords:
gastric cancerintraperitoneal chemotherapyrecurrence and metastasisprognosis
分类号:
R735.2
DOI:
10.16571/j.cnki.2097-2768.2025.01.008
文献标志码:
A
摘要:
目的 探讨腹腔化疗联合全身化疗对进展期胃癌患者术后复发转移及预后的影响。方法纳入2020年1月至2021年3月在哈励逊国际和平医院收治的200例行胃癌根治手术的III期(进展期)胃癌患者。将所有患者分为对照组(给予奥沙利铂联合替吉奥的全身化疗方案)和腹腔化疗组(在对照组患者治疗方法基础上联合腹腔化疗:腹腔灌注紫杉醇),每组100例。所有患者治疗6~8周,每个周期21 d。收集对比两组患者一般临床资料,围手术期不良反应,术后肿瘤标志物表达水平及病灶转移情况。最后,随访分析患者1年和3年患者生存率。结果腹腔化疗组患者腹痛和腹泻发生率明显高于对照组(P<0.05)。腹腔化疗组1年和3年的腹膜复发转移发生率较对照组明显降低(P<0.05)。术后两组患者肿瘤标志物CEA、CA125与CA19-9表达水平较术前明显降低(P<0.05),且腹腔化疗组患者指标水平下降程度更明显(P<0.05)。腹腔化疗组患者随访1年和3年生存率较对照组明显升高(P<0.05)。结论腹腔化疗联合全身化疗可有效降低进展期胃癌患者1年和3年的术后腹膜复发转移发生率,提高患者的预后。同时,该治疗方案安全性良好,无严重的治疗相关不良事件。这一治疗策略有望成为进展期胃癌患者术后综合治疗的重要组成部分。
Abstract:
Objective To investigate the effects of combined intraperitoneal chemotherapy(IPC)and systemic chemotherapyon postoperative recurrence,metastasis,and prognosis in patients with advanced gastric cancer. Methods A total of 200 patientswith advanced gastric cancer who underwent radical surgery at the Harrison International Peace Hospital from January 2020 to March2021 were selected. Among them,100 patients in the control group received oxaliplatin combined with tegafur for systemic chemothera?py only,while the other 100 in the IPC group received IPC in addition to the treatment received by the control group(intraperitoneal in?fusion of paclitaxel). All patients were treated for 6-8 weeks with a cycle of 21 days. General clinical data,perioperative adverse reac?tions,postoperative tumor marker expression levels,and metastatic le?sions were collected and compared between the two groups. Finally,the survival rates of patients were followed up at 1 year and 3 years.Results The incidence of abdominal pain and diarrhea in the IPCgroup was significantly higher than that in the control group (P<0.05). The incidence of peritoneal recurrence and metastasis at 1 and3 years in the IPC group was significantly lower than that in the con?trol group(P<0.05). After surgery,the expression levels of tumor markers CEA,CA125 and CA19-9 in 2 groups were significantly decreased compared with those before surgery(P<0.05),and the levelof indexes in the IPC group was more significantly decreased(P<0.05). The 1-year and 3-year survival rates in the IPC group were sig?nificantly higher than those in the control group(P<0.05). Conclusion Combined IPC and systemic chemotherapy can effectivelyreduce the rates of postoperative peritoneal recurrence and metastasis in patients with advanced gastric cancer at 1 year and 3 years,thereby improving patient prognosis. Moreover,this treatment regimen is safe and associated with no severe treatment-related adverseevents. This therapeutic strategy is expected to become an important component of comprehensive postoperative treatment for patientswith advanced gastric cancer.

参考文献/References:

[1] Han B,Zheng R,Zeng H,et al.Cancer incidence and mortality inChina,2022[J].J Natl Cancer Cent,2024,46(3):221-231.[2] Zeng L,Huang X,Tian Y,et al.Tumor mutational burden associ?ated with response to hyperthermic intraperitoneal chemotherapy[J].Front Oncol,2022,12: 796263.[3] 朱正纲.预防与治疗胃癌腹膜转移的若干关键问题[J].外科理论与实践,2021,26(1): 1-6.[4] 张芮毫,张明.进展期胃癌抗HER2治疗研究进展[J].医学研究生学报,2022,35(2): 218-224.[5] Brandl A,Prabhu A.Intraperitoneal chemotherapy in the treatmentof gastric cancer peritoneal metastases: an overview of commontherapeutic regimens[J].J Gastrointest Oncol,2021,12(Suppl1): S32-S44.[6] Roviello F,Marrelli D,De Manzoni G,et al.Prospective study ofperitoneal recurrence after curative surgery for gastric cancer[J].Br J Surg,2003,90(9): 1113-1119.[7] Kitayama J,Ishigami H,Yamaguchi H,et al.Treatment of patientswith peritoneal metastases from gastric cancer[J].Ann Gastroen?terol Surg,2018,2(2): 116-123.[8] Yarema R,Mielko J,Fetsych T,et al.Hyperthermic intraperitone?al chemotherapy(HIPEC)in combined treatment of locally ad?vanced and intraperitonealy disseminated gastric cancer: a retro?spective cooperative Central?Eastern European study[J].CancerMed,2019,8(6): 2877-2885.[9] 中华人民共和国国家卫生健康委员会医政医管局.胃癌诊疗指南(2022年版)[J].中华消化外科杂志,2022,21(9): 1137-1164.[10] 陕飞,李子禹,张连海,等.国际抗癌联盟及美国肿瘤联合会胃癌TNM 分期系统简介及解读[J].中国实用外科杂志,2017,37(1): 15-17.[11] Kobayashi D,Kodera Y.Intraperitoneal chemotherapy for gastriccancer with peritoneal metastasis[J].Gastric Cancer,2017,20(Suppl 1): 111-121.[12] Jacquet P,Sugarbaker PH.Peritoneal-plasma barrier[J].CancerTreat Res,1996,82: 53-63.[13] Ajani JA,Bentrem DJ,Besh S,et al. Gastric cancer,version2.2013[J].J Natl Compr Canc Netw,2013,11(5): 531-546.[14] Feingold PL,Kwong MLM,Davis JL,et al.Adjuvant intraperito?neal chemotherapy for the treatment of gastric cancer at risk forperitoneal carcinomatosis: a systematic review[J].J Surg Oncol,2017,115(2): 192-201.[15] Mi DH,Li Z,Yang KH,et al.Surgery combined with intraopera?tive hyperthermic intraperitoneal chemotherapy(IHIC)for gas?tric cancer: a systematic review and meta-analysis of randomisedcontrolled trials[J].Int J Hyperthermia,2013,29(2): 156-167.[16] Emoto S,Ishigami H,Hidemura A,et al.Complications and man?agement of an implanted intraperitoneal access port system forintraperitoneal chemotherapy for gastric cancer with peritonealmetastasis[J].Jpn J Clin Oncol,2012,42(11): 1013-1019.[17] 薛侃,李子禹,闫国军,等.腹腔化疗港在胃癌腹膜转移中应用的安全性分析[J].中国肿瘤临床,2019,46(1): 34-38.[18] 张利,林莉,徐敏.多西紫杉醇腹腔灌注治疗晚期胃癌疗效及其护理[J].中国医药科学,2011,1(17): 17-18.[19] 蔡高平,余阳.奥沙利铂联合腹腔热灌注化疗在进展期胃癌根治术后早期应用的安全性和疗效评估[J].江汉大学学报(自然科学版),2024,52(1): 55-65.[20] Deng K,Yang L,Hu B,et al.The prognostic significance of pre?treatment serum CEA levels in gastric cancer: a meta-analysis in?cluding 14651 patients[J].PLoS One,2015,10(4): e0124151.[21] 朱敏,崔德军,叶丽敏,等.血清miRNA-182联合癌胚抗原对胃癌的诊断效能及临床意义[J].医学研究生学报,2021,34(1): 68-73.[22] Wang W,Chen XL,Zhao SY,et al.Prognostic significance of pre?operative serum CA125,CA19- 9 and CEA in gastric carcinoma[J].Oncotarget,2016,7(23): 35423-35436.[23] 张国胜.围手术期腹腔热灌注对进展期胃癌的疗效分析[J].中国现代普通外科进展,2013,16(11): 896-898.[24] Desiderio J,Chao J,Melstrom L,et al.The 30-year experience-Ameta -analysis of randomised and high-quality non-randomisedstudies of hyperthermic intraperitoneal chemotherapy in thetreatment of gastric cancer[J].Eur J Cancer,2017,79: 1-14.

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备注/Memo

备注/Memo:
基金项目:衡水市科技计划项目(2023014025Z)
更新日期/Last Update: 2025-01-20