作者:王治全，孔平孝，李强，张庆，李宏晓
【摘要】 目的 对照研究30例白及混合微粒、125碘（125I）在进展期胃癌手术中组织间近距离持续低能量放化疗和全身静脉化疗的近期疗效、远期疗效和毒副反应。方法 随机分为胃癌手术、近距离放化疗组（治疗组）30例和静脉化疗组（对照组）30例，记录观察近期疗效和毒副反应，随访患者生存期。采用Kaplan-Meier法估计生存函数，Log rank检验两组生存函数的差异。结果 近期疗效两组基本接近，毒副反应中恶心、呕吐、骨髓抑制症状、生存质量治疗组明显低于对照组。中位生存期和1年生存率显著高于对照组。结论 对进展期胃癌患者进行组织间近距离持续低能量放化疗，可提高生存质量，延长患者生存期。
【关键词】 混合微粒； 125I； 近距离放化疗； 进展期胃癌
The research on Baiji mixed particle and 125I in radiotherapy and chemotherapy among tissues during the progressive stage of stomach cancer
【Abstract】 Objective To study 30 examples about the recent curative effect， long-term curative effect and reaction to poison of Baiji mixed particle and 125I， by continuous radiotherapy and chemotherapy with low energy among tissues in a near distance and chemotherapy during the operation for stomach cancer which is in progressive stage.Methods It’s divided at random into the group of radiotherapy and chemotherapy in a near distance in an operation for stomach cancer (the treatment group)， there are 30 examples and chemotherapy via veins (the contrast group) also including 30 examples， recording and observing the recent curative effect and reaction to poison， making attendant interview about patient’s lifespan.The Kaplan-Meier method is adopted to estimate the function of survival， Log rank are used to inspect the distinction of the survival function between the two groups. Results The two groups in recent curative effect get close basically. Concerning the symptom of nausea， vomiting and of marrow inhibition， it’s apparent that the quality of existence in the treatment group is lower than that of the contrast group. Lifespan of medium time and the survival rate in 3 years are remarkably higher than those of the contrast group， by the inspection of statistics， P<0.05， there is a noticeable difference. Conclusion Carry out continuous radiotherapy and chemotherapy with low energy among tissues in a near distance on patient suffering stomach cancer， which is in progressive stage，can improve the quality of existence and prolonged the patient’s lifespan.
【Key words】 mixed particle；125I； radiotherapy and chemotherapy in a near distance； progressive stomach cancer
近年来，放射性粒子植入治疗肿瘤技术，逐渐应用在中晚期恶性肿瘤的辅助治疗，取得了一定的治疗效果，我们提出对进展期胃癌病人在术中进行白及混合微粒局部化疗、125I腹腔内组织间近距离低能量持续放疗研究，充分发挥局部药物浓度高、作用直接、维持时间长、全身毒性低的优势，减少和控制中晚期恶性肿瘤患者术后复发或转移，并能得到有效的治疗。
1 材料与方法
1.1 一般资料 2002年6月～2005年8月间住院病人60例，男47例，女13例，平均年龄48.6岁。随机分为进展期胃癌近距离放化疗组（治疗组）30例和全身静脉化疗组（对照组）30例，其中进展期胃癌Ⅱ期16例，Ⅲ期14例；对照组30例，其中Ⅱ期18例，Ⅲ期12例。