Ⅲ期贲门胃底癌患者术前药物诱导性高压化疗的临床试验研究
Clinical Trial of Preoperative Induced Hypertension Chemotherapy on Stage-III Carcinoma of Gastric Cardia or Fundus of the Stomach
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摘要: 目的:探讨术前药物诱导性高压化疗治疗Ⅲ期贲门胃底癌的疗效和不良反应。方法:49例Ⅲ期贲门胃底癌患者随机分成观察组19例,对照组30例,术前均接受1周期化疗。观察组(IHC组)采用化疗+血管紧张素Ⅱ(ATⅡ),对照组(单纯化疗组)采用单纯化疗。两组患者均休息3周后接受手术。术后标本经流式细胞仪进行DNA分析。结果:观察组有效率63.2%(12/19),手术切除率84.2%(16/19),对照组有效率30.0%(9/30),手术切除率63.3%(19/30)。DNA倍体测定:观察组两倍体13例,异倍体5例;对照组两倍体9例,异倍体16例。两组患者均未增加手术并发症及手术风险。结论:术前药物诱导性高压化疗可明显提高Ⅲ期贲门胃底癌患者的疗效。开展IHC是一项很有前途的化疗途径,值得临床扩大实验。Abstract: Objective: To observe the therapeutic effect and adverse reaction of preoperative induced hypertension chemotherapy on stage-III carcinoma of gastric cardia or fundus of the stomach. Methods: Forty-nine cases with stage-III carcinoma of gastric cardia or fundus of the stomach were divided into two groups at random. Nineteen cases were included in the experimental group and 30 were in the control group. Each case received one cycle of chemotherapy. A regimen of chemotherapy in addition to AT·was used in the experimental group. A single chemotherapy treatment was administered in the control group. The patients in both groups had surgery 3 weeks after the chemotherapy treatment. The specimens were analyzed for ploidy using flowcytometry. Results: The combined treatment was effective in 63.2% (12/19) of the cases in the experimental group, and the surgical removal rate in that group was 84.2% (16/19). The single treatment was effective in 30% (9/30) of the control group, and the surgical removal rate was 63.3% (19/30). The results of DNA ploidy determination were as follows: there were 13 diploid and 5 aneuploid cases in the experimental group, while there were 9 diploid and 16 aneuploid cases in the controls . Surgery-related complications and associated risk were not significant in either group. Conclusion: IHC can significantly increase the therapeutic effect of treatment for stage-III carcinoma of gastric cardia or fundus of the stomach. IHC is a potential chemotherapeutic regimen that is worthwhile for further clinical study.