临床外科杂志 ›› 2023, Vol. 31 ›› Issue (3): 256-260.doi: 10.3969/j.issn.1005-6483.2023.03.018

• 论著 • 上一篇    下一篇

阿帕替尼联合腹腔热灌注及静脉化疗治疗晚期胃癌腹膜转移转化治疗的效果

  

  1. 048000 山西省晋城市人民医院普外科
  • 收稿日期:2022-07-09 出版日期:2023-03-20 发布日期:2023-03-20
  • 通讯作者: 周常青,Email:zcqchangqing@126.com

Effect of apatinib combined with intraperitoneal hyperthermic perfusion and intravenous chemotherapy in the treatment of advanced gastric cancer with peritoneal metastases and transformation

  1. Department of General Surgery,Jincheng People’s Hospital,Shanxi,Jincheng  048000, China
  • Received:2022-07-09 Online:2023-03-20 Published:2023-03-20

摘要: 目的 探讨阿帕替尼联合腹腔热灌注及静脉化疗在晚期胃癌腹膜转移转化治疗的效果。方法 2017年7月~2021年4月收治的晚期胃癌腹膜转移病人80例,根据治疗方法分为两组,对照组39例,行腹腔热灌注及静脉化疗,研究组41例,行阿帕替尼联合腹腔热灌注及静脉化疗,两组病人均治疗2个周期后评价效果,随访1年。比较两组近期疗效、肿瘤标志物、药物安全性,比较两组手术切除情况、肿瘤退缩情况及随访期间生存情况。结果 研究组客观缓解率、临床控制率高于对照组,差异有统计学意义(P<0.05)。两组治疗后癌胚抗原(CEA)、糖类抗原199(CA199)水平均降低,差异有统计学意义(P<0.05),研究组治疗后的CEA、CA199水平均低于对照组,差异有统计学意义(P<0.05)。两组白细胞减少、中性粒细胞减少、乏力、贫血、手足综合征、蛋白尿发生率对比差异均无统计学意义(P>0.05)。研究组R0切除率高于对照组,肿瘤退缩分级(TRG)优于对照组,1年总存活率高于对照组,两组比较差异有统计学意义(P<0.05)。结论 阿帕替尼联合腹腔热灌注及静脉化疗用于晚期胃癌腹膜转移转化治疗疗效显著,提高R0切除率,改善TRG,延长病人近期生存率且安全性良好。

关键词: 晚期胃癌, 腹膜转移, 转化治疗, 阿帕替尼HJ0.75mm

Abstract: Objective To investigate the effect of apatinib combined with intraperitoneal hyperthermia and intravenous chemotherapy in the treatment of advanced gastric cancer with peritoneal metastasis.Methods The clinical data of 80 patients with advanced gastric cancer peritoneal metastasis admitted to the hospital from July 2017 to April 2021 were retrospectively analyzed.Among them,39 patients were given intraperitoneal hyperthermic perfusion and intravenous chemotherapy (referred to as the control group),and 41 patients were given apatinib combined with intraperitoneal hyperthermic perfusion and intravenous chemotherapy (referred to as the study group).The effect was evaluated were evaluated after 2 cycles of treatment in both groups.The patients were followed up for 1 year.The short-term efficacy,tumor markers,and drug safety of the two groups were compared,and the surgical resection,tumor regression,and survival during follow-up were compared between the two groups.Results The objective remission rate and clinical control rate in the study group were higher than those in the control group (P<0.05).After treatment,the levels of carcinoembryonic antigen (CEA) and Carbohydrate antigen 199 (CA199) in the two groups were decreased (P<0.05).The levels of CEA and CA199 were lower than control group after treatment(P<0.05).There was no significant difference in the incidence of leukopenia,neutropenia,fatigue,anemia,hand-foot syndrome and proteinuria between the two groups (P>0.05).The R0 resection rate in the study group was higher than that in the control group (P<0.05).The 1 year overall survival rate of study group was higher than control group (P<0.05).Conclusion Apatinib combined with intraperitoneal hyperthermic perfusion and intravenous chemotherapy has a significant curative effect in the treatment of advanced gastric cancer with peritoneal metastases and transformation.It can reduce the level of tumor markers,increase the R0 resection rate,improve TRG,and prolong the short-term survival rate of patients with good safety.

Key words: advanced gastric cancer, peritoneal metastasis, conversion therapy, apatinib

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