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应用选择性动脉灌注化疗方法治疗晚期胃癌35例。男性30例,女性5例,平均年龄为58岁(20~69岁);其中低分化腺癌25例,其它病理类型10例;临床分期Ⅲ期7例,Ⅳ期28例。采用Seldinder插管法,经股动脉插入,将导管前端置入腹腔动脉,再根据肿瘤部位进行超选,化疗药物有ADM 50mg,DDP100mg,MMC10mg,Vp16 20mg,5-Fu 1.0,一般选择三种配伍联合用药;共计行1次治疗者22例,2次11例,3次2例。治疗后主观症状改善者86%(28/35),有效率为40%(14/35),低分化腺癌有效率为48%(12/25),临床置期有效率为71%(5/7),Ⅳ期有效率为32.1%(9/28),治疗后1年生存率为22.5%(7/31),毒副反应轻。结果表明动脉灌注化疗方法治疗晚期胃癌,改善了因全身化疗的毒副反应并提高了临床疗效及病员生存质量,但确切的疗效评价与生存率的提高尚有待进一步探讨。
Thirty-five patients with advanced gastric cancer were treated with selective arterial infusion chemotherapy. There were 30 males and 5 females with an average age of 58 years (range, 20-69 years); 25 poorly differentiated adenocarcinomas and 10 other pathological types; 7 clinical stages III and 28 stage IV. Using Seldinder cannulation, inserted through the femoral artery, the catheter tip was placed into the celiac artery, and then superselected according to the tumor site. Chemotherapy drugs were ADM 50mg, DDP100mg, MMC10mg, Vp16 20mg, 5-Fu 1.0, generally choose the three compatibility Combined medications; 22 patients were treated in total for 1 treatment, 2 in 11 and 3 in 3 treatments. 86% (28/35) of the subjective symptoms improved after treatment, the effective rate was 40% (14/35), the effective rate of poorly differentiated adenocarcinoma was 48% (12/25), and the effective rate of clinical home placement was 71% (5 /7), The effective rate of stage IV was 32.1% (9/28), the 1-year survival rate after treatment was 22.5% (7/31), and the toxicity was mild. The results showed that arterial infusion chemotherapy for the treatment of advanced gastric cancer, improve the toxic and side effects of systemic chemotherapy and improve the clinical efficacy and quality of life of patients, but the exact evaluation of the efficacy and survival rate remains to be further explored.