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目的探讨经胃左动脉介入灌注化疗治疗晚期贲门癌的近期疗效和2年生存率。方法将2008年10月至2010年4月间收治的88例晚期贲门癌患者随机单盲分为观察组(45例)和对照组(43例),观察组患者采用胃左动脉介入灌注DCF化疗方案,对照组患者采用常规静脉输注DCF化疗方案,两组均用药3个周期,记录化疗期间两组患者的不良反应,化疗结束后1个月内对比两组患者的近期疗效,并进行为期2年的随访观察,记录2年生存率。结果 (1)化疗结束后1个月时,观察组患者完全缓解(CR)2例,部分缓解(PR)25例,总有效率为60.0%(27/45);对照组完全缓解0例,部分缓解(PR)17例,总有效率为39.5%(17/43),差异有统计学意义(P<0.05)。(2)观察组患者Ⅱ度以上骨髓抑制、肝功能损害、末梢神经损害和胃肠道反应比例低于对照组(28.9%和51.2%、17.8%和39.5%、15.6%和34.9%、42.2%和67.4%),差异均有统计学意义(均P<0.05);(3)观察组患者2年随访期内死亡者平均存活时间为(15.1±2.9)个月,长于对照组的(13.3±2.4)个月,差异有统计学意义(P<0.05)。结论经胃左动脉介入灌注化疗药物较全身化疗能有效提高近期疗效,降低不良反应,并延长患者生存时间。
Objective To investigate the short-term curative effect and 2-year survival rate of gastric cardia cancer treated with transgastric artery interventional chemotherapy. Methods Eighty-eight patients with advanced cardia cancer admitted from October 2008 to April 2010 were randomly divided into observation group (45 cases) and control group (43 cases). Patients in the observation group were treated with DCF chemotherapy Program, the control group of patients with conventional intravenous infusion of DCF chemotherapy, two groups were treated with three cycles, record the adverse reactions of two groups of patients during chemotherapy, chemotherapy within one month after the end of the two groups compared the short-term efficacy and duration 2-year follow-up observation, record 2-year survival rate. Results (1) At 1 month after the end of chemotherapy, 2 cases of complete remission (CR), 25 cases of partial remission (PR), the total effective rate was 60.0% (27/45) in the observation group and 0 cases in the control group The partial response (PR) in 17 cases, the total effective rate was 39.5% (17/43), the difference was statistically significant (P <0.05). (2) The proportion of bone marrow suppression, hepatic dysfunction, peripheral nerve damage and gastrointestinal reaction in patients in observation group was lower than those in control group (28.9% and 51.2%, 17.8% and 39.5%, 15.6% and 34.9%, 42.2% and (P <0.05). (3) The average survival time of the deceased in the observation group was (15.1 ± 2.9) months, which was longer than that of the control group (13.3 ± 2.4), the difference was statistically significant ) Months, the difference was statistically significant (P <0.05). Conclusion Interventional chemotherapy with chemotherapeutic drugs through the left gastric artery can improve the short-term curative effect, reduce the adverse reactions and prolong the survival time of patients compared with systemic chemotherapy.