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目的评价口服替吉奥(S-1)联合腹腔热灌注化疗治疗晚期胃癌合并有腹腔积液临床疗效、生活质量及其毒副作用。方法 56例晚期胃癌患者分为实验组和对照组,试验组28例,予替吉奥40 mg/m2,口服第1—14天;同时予腹腔热灌注化疗:先放出腹腔积液,后向腹腔内注入生理盐水1 500~2 500 mL+顺铂50 mg/m2,腹腔持续热循环1 h,结束前腹腔内注射速尿80 mg,地塞米松10 mg,第1,5天,3周为1周期,2周期后评定疗效。对照组28例,予替吉奥40 mg/m2,口服第1—14天;同时予腹腔化疗:先放出腹腔积液,后向腹腔内注入生理盐水500 mL+顺铂50mg/m2,速尿80 mg,地塞米松10 mg,第1,5天,3周为1周期,2周期后评定疗效。结果试验组PR 18例,有效率为64%,对照组PR 13例,有效率为46%,2组比较有显著性差异(P<0.05);实验组生活质量Karnofsky评分高于对照组,2组比较有显著性差异(P<0.05);实验组血液毒副反应、胃肠道反应与对照组比较无显著性差异(P>0.05)。结论口服替吉奥(S-1)联合顺铂腹腔热灌注化疗治疗晚期胃癌合并腹腔积液疗效好,安全性高,可作为晚期胃癌合并腹腔积液较好的治疗方法。
Objective To evaluate the clinical efficacy, quality of life and side effects of oral administration of tegaserod (S-1) in combination with intraperitoneal hyperthermic perfusion chemotherapy for advanced gastric cancer with ascites. Methods 56 cases of advanced gastric cancer patients were divided into experimental group and control group, the experimental group 28 cases, instead of Gio 40 mg / m2 orally for days 1-14; the same time to intraperitoneal hyperthermic perfusion chemotherapy: first release of ascites, Intraperitoneal injection of normal saline 1 500 ~ 2 500 mL + cisplatin 50 mg / m2, intraperitoneal continuous thermal cycling 1 h, before the end of intraperitoneal injection of furica in 80 mg, dexamethasone 10 mg, first day 1,5, 3 weeks 1 cycle, 2 cycles after the assessment of efficacy. Control group, 28 cases, instead of Gio 40 mg / m2, oral administration of 1-14 days; the same time to intraperitoneal chemotherapy: first release of ascites, after injection of saline into the abdominal cavity of 500 mL + cisplatin 50mg / m2, furosemide 80 mg, dexamethasone 10 mg, on the first and fifth days, three weeks for a period of 2 weeks after the assessment of efficacy. Results In the experimental group, the effective rate was 64% in the PR group and 13 cases in the control group, the effective rate was 46%. There was significant difference between the two groups (P <0.05). The Karnofsky score of the experimental group was higher than that of the control group, 2 (P <0.05). There was no significant difference in the blood toxic and gastrointestinal reactions between the two groups (P> 0.05). Conclusion Intraperitoneal hyperthermic perfusion chemotherapy of T-1 combined with cisplatin is effective and safe in the treatment of advanced gastric cancer combined with ascites, which can be used as a better treatment for advanced gastric cancer combined with ascites.