腹膜癌病的防治:结合活性碳粒的丝裂霉素C腹腔内化疗

来源 :国外医学.外科学分册 | 被引量 : 0次 | 上传用户:dajianshi
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腹膜癌病是胃癌手术后最常见的复发形成,为了破坏腹腔内和淋巴组织内的癌细胞,作者采用丝裂霉素C结合在活性碳粒上(MMC—CH)并由腹腔内注入.碳粒具有许多微孔,可以吸收大量丝裂霉素C,随后缓慢释出.活性碳粒经细研和筛滤处理,81%小于40μm,干热120℃凡2小时以去除潮气,置375mg于试管内,将50mg丝裂霉素C溶于100ml盐水中,加入上述活性碳粒,摇荡10分钟,制成MMC-CH备用.1987~1992年间日本Kyoto大第学一外科曾行胃癌根治术113例,均属局部晚期癌肿并伴浆膜层浸润,年龄70岁以下,心、肾和肝功能正常,白细胞值>3×10~9/L,血小板>100×10~9/L,列入研究对象,随机分成两组,对照组57例,MMC-CH,即丝裂霉素C50mg、活性碳粒375mg和盐水100ml.未用其它化疗药物.两组各有1例失访.试验组和对照组中,浆膜浸润S_2分别占39例和37例,S_3占17例和20例;Bormann分型Ⅲ级分别为26例和28例,Ⅳ级为24例和22例;分化不良或未分化癌分别占41例和32例.两组的手术范围大致也相仿.试验组的2年和3年生存率分别为42%和38%,对照组则为28%和20%,两组差别有显著性(P<0.05).两组伴有巨体腹膜癌病 P_1~P_3期的生存曲线差别不明显.以治愈性手术而论,试验组的2年和3年生存率分别为66%和66%,对照组则为35%和20%(P<0.01). 在试验组中,术后白细胞值 Peritoneal cancer is the most common form of recurrence after gastric cancer surgery. To destroy cancer cells in the abdominal cavity and lymphoid tissues, the authors used mitomycin C in combination with activated carbon particles (MMC-CH) and injected intraperitoneally. The granules have many micropores and can absorb a large amount of mitomycin C, and then slowly release. The activated carbon particles are finely ground and sieved, 81% is less than 40μm, dry heat 120°C for 2 hours to remove moisture, set 375mg in In vitro, 50 mg of mitomycin C was dissolved in 100 ml of saline, and the above activated carbon particles were added and shaken for 10 minutes to make MMC-CH reserve. Between 1987 and 1992, Kyoto University School of Medicine had undergone radical surgery for gastric cancer. 113 Cases are locally advanced cancer with serosal infiltration, age less than 70 years old, heart, kidney and liver function normal, white blood cell value> 3 x 10~9/L, platelet> 100 x 10~9/L, column The study subjects were randomly divided into two groups, the control group of 57 patients, MMC-CH, namely mitomycin C50mg, activated carbon particles 375mg and saline 100ml. No other chemotherapy drugs were used. One patient in each group was lost to follow-up. In the control group, serosal infiltration S_2 accounted for 39 cases and 37 cases respectively, S_3 accounted for 17 cases and 20 cases; Bormann type III were 26 cases and 28 cases respectively, and IV degree was 24 cases and 22 cases; Poorly or undifferentiated cancers accounted for 41 cases and 32 cases, respectively. The surgical range of the two groups was roughly similar. The 2-year and 3-year survival rates of the experimental group were 42% and 38%, respectively, and the control group was 28% and 20%. There was a significant difference between the two groups (P<0.05). There was no significant difference in survival curves between the two groups with peritoneal carcinomatosis of the peritoneal P_1 to P_3 phases. In terms of curative surgery, the 2-year and 3-year survival rates of the experimental group were At 66% and 66%, the control group was 35% and 20% (P < 0.01). In the test group, the postoperative leukocyte value
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