作者：梁松，江频，王传军，梁永康，张同方，鲁修明，李小祺

单位：安徽医科大学附属六安医院（六安市人民医院）普通外科，安徽 六安 237000

Authors: Liang Song, Jiang Pin, Wang Chuanjun, Liang Yongkang, Zhang Tongfang, Lu Xiuming, Li Xiaoqi

Unit:  Department of General Surgery, Lu'an Hospital of Anhui Medical University (Lu'an People's Hospital), Lu'an 237000, Anhui, China

摘要：

目的  分析全身性与腹腔内联合双向化疗在进展期胃癌患者根治术后腹膜复发转移中的应用效果及生存获益情况。方法  回顾性选取2018 年1月至2020年12月安徽医科大学附属六安医院收治的106例进展期胃癌根治术后腹膜复发转移患者的临床资料，根据化疗方式的不同进行分组，接受腹腔内联合双向化疗的57例患者纳入观察组，接受全身性化疗的49例患者纳入对照组。比较两组患者腹膜癌指数（peritoneal cancer index，PCI）评分、毒副反应、生活质量及生存获益情况。结果  化疗后，观察组PCI评分低于对照组，差异有统计学意义（P＜0.05）；两组患者毒副反应差异无统计学意义（P＞0.05）；观察组化疗后症状、躯体和情绪功能、整体生活质量和单项测量项目评分均高于对照组（P＜0.05）；观察组2年生存率（38.60%）高于对照组（18.37%），差异有统计学意义（P＜0.05）；观察组中位无复发生存时间为15个月，对照组为8个月，差异有统计学意义（P＜0.05）。结论  相比于全身性化疗，将腹腔内联合双向化疗应用于进展期胃癌患者根治术后腹膜复发转移的治疗中，可提高生存率和生活质量，延长无复发生存时间，未明显增加毒副反应。

关键词： 腹腔；双向化疗；进展期胃癌；腹膜复发转移；生存情况

Abstract：

Objective   To analyze the application effect and survival benefit of systemic and intraperitoneal combined bidirectional chemotherapy in peritoneal recurrence and metastasis in patients with advanced gastric cancer after radical operation. Method  The clinical data of 106 patients who had peritoneal recurrence and metastasis after radical gastrectomy for advanced gastric cancer and were admitted to the Lu'an Hospital of Anhui Medical University from January 2018 to December 2020 were analyzed retrospectively. Among the patients enrolled, 57 patients underwent intraperitoneal combined bidirectional chemotherapy (observation group) and 49 patients underwent systemic chemotherapy (control group). The peritoneal cancer index (PCI) score, toxicities, quality of life and survival benefit were compared between the 2 groups. Result  After treatment, PCI score of the observation group was lower than that of the control group (P<0.05). There was no statistical difference in toxicities between the 2 groups (P>0.05). After treatment, the scores for symptoms, physical and emotional function, overall quality of life and each survival rate in the observation group (38.60%) was higher than that in the control group (18.37%) (P<0.05). The median recurrence-free survival time of the observation group and the control group was 15 months and 8 months, respectively, with a statistically significant difference (P<0.05). Conclusion  Compared with systemic chemotherapy, intraperitoneal combined bidirectional chemotherapy can improve survival rate and quality of life, and prolong recurrence-free survival time of patients with peritoneal recurrence and metastasis after radical operation for advanced gastric cancer, without significantly increasing toxicities.

Key Words:  Abdominal cavity; Bidirectional chemotherapy; Advanced gastric cancer; Peritoneal recurrence and metastasis; Survival status

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