| 徐天洋,陆 斌,童瑞敏,等.腹腔常温灌注化疗联合深部热疗辅助治疗胃癌术后患者的临床疗效[J].肿瘤学杂志,2026,32(5):398-403. |
| 腹腔常温灌注化疗联合深部热疗辅助治疗胃癌术后患者的临床疗效 |
| Efficacy of Adjuvant Normothermic Intraperitoneal Chemotherapy Combined with Deep Hyperthermia for Postoperative Gastric Cancer |
| 投稿时间：2025-09-04 |
| DOI：10.11735/j.issn.1671-170X.2026.05.B007 |
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| 中文关键词: 胃肿瘤 腹腔灌注化疗 常温 热疗 辅助治疗 无病生存期 |
| 英文关键词:stomach neoplasms intraperitoneal chemotherapy normothermia hyperthermia adjuvant therapy disease-free survival |
| 基金项目:镇江市科技计划资助（SH2024057） |
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| 中文摘要: |
| 摘 要：［目的］ 探讨腹腔常温灌注化疗（normothermic intraperitoneal chemotherapy，NIPEC）联合深部热疗辅助治疗进展期胃癌术后患者的临床疗效。［方法］ 130例进展期胃癌患者分为试验组和对照组，每组各65例。对照组采用SOX方案（奥沙利铂+替吉奥）术后辅助化疗，试验组采用SOX方案术后辅助化疗联合紫杉醇NIPEC及深部热疗，比较分析两组患者的2年无病生存期（disease-free survival，DFS）率、安全性、胆汁酸以及中性粒细胞与淋巴细胞比值（neutrophil to lymphocyte ratio，NLR）水平，并分析DFS的影响因素。［结果］ 试验组和对照组2年DFS率分别为80.0%、55.4%（P＜0.001），且临床Ⅲ期的患者对本干预方案的敏感性更高（P＜0.001）。试验组血清胆汁酸水平从治疗前（7.38±10.18） μmmol/L下降到治疗后的（4.01±5.11） μmmol/L（t=3.459，P=0.001），对照组从治疗前（7.63±8.42） μmmol/L下降到治疗后的（6.90±8.47） μmmol/L（t=0.961，P=0.340）。试验组NLR从治疗前1.83±1.03下降到治疗后的1.42±0.78（t=4.642，P<0.001），对照组NLR从治疗前1.78±1.26下降到治疗后的1.77±1.09（t=0.029，P=0.977）。多因素Cox回归分析表明，术后化疗方式以及胃癌N分期是影响患者2年DFS的主要影响因素。试验组和对照组3~4级不良反应发生率差异无统计学意义（18.46% vs 30.77%，χ2=2.653，P=0.103）。［结论］ 腹腔NIPEC联合深部热疗是进展期胃癌术后辅助治疗的有效方法。 |
| 英文摘要: |
| Abstract：［Objective］ To evaluate the efficacy of normothermic intraperitoneal chemotherapy (NIPEC) combined with deep hyperthermia as adjuvant treatment for advanced gastric cancer after surgery. ［Methods］ A total of 130 patients with advanced gastric cancer were randomly assigned to a study group (n=65) or a control group (n=65). The control group received postoperative adjuvant chemotherapy with the SOX regimen(Oxaliplatin + S-1). The study group received the SOX regimen combined with paclitaxel-based NIPEC and deep hyperthermia. The 2-year disease-free survival (DFS) rate， safety profile， and levels of serum bile acid and neutrophil-to-lymphocyte ratio (NLR) were compared between the two groups. Risk factors for DFS were also analyzed. ［Results］ The 2-year DFS rate was significantly higher in the study group than in the control group (80.0% vs 55.4%， P<0.001). This benefit was particularly pronounced in patients with clinical stage Ⅲ disease(P<0.001). Serum bile acid levels decreased significantly after treatment in the study group from (7.38±10.18) μmol/L to (4.01±5.11) μmol/L (t=3.459， P=0.001)， but not in the control group from (7.63±8.42) μmol/L to (6.90±8.47) μmol/L (t=0.961， P=0.340). Similarly， NLR decreased significantly in the study group (1.83±1.03 vs 1.42±0.78， t=4.642， P<0.001)， but remained unchanged in the control group (1.78±1.26 vs 1.77±1.09， t=0.029， P=0.977). Multivariate Cox regression analysis identified the treatment regimen and gastric cancer N stage as independent risk factors affecting 2-year DFS. The incidence of grade 3~4 adverse events did not differ significantly between the two groups (18.46% vs 30.77%， χ2=2.653， P=0.103). ［Conclusion］ The combination of NIPEC and deep hyperthermia is an effective and safe adjuvant therapy that improves 2-year DFS in patients with advanced gastric cancer after surgery. |
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