• 江蘇省中醫(yī)院消化腫瘤外科(江蘇南京210029);

目的探討CHOP化療方案行術(shù)前區(qū)域性動(dòng)脈灌注治療原發(fā)性胃惡性淋巴瘤(PGML)的可行性。方法回顧性研究1995~2010年期間我院收治的74例PGML患者，其中41例術(shù)前接受胃區(qū)域性動(dòng)脈灌注化療即術(shù)前動(dòng)脈介入化療組，方案選用CHOP聯(lián)合化療方案: 環(huán)磷酰胺600 mg/m2，第1天; 表阿霉素50 mg/m2，第1天; 長(zhǎng)春新堿1.4 mg/m2，第1天; 強(qiáng)的松60 mg/m2 口服，第1~5天。14～21 d后接受手術(shù)。同期33例PGML患者行常規(guī)手術(shù)治療即常規(guī)手術(shù)組。比較動(dòng)脈介入化療后腫瘤的緩解情況、毒副反應(yīng)及2組間的療效差異。 結(jié)果常規(guī)手術(shù)組24例(72.7%)獲得根治性切除，5年生存率為58.3%(14/24)。術(shù)前動(dòng)脈介入化療組全部完成術(shù)前區(qū)域性動(dòng)脈化療，毒副作用主要為胃腸道反應(yīng)22例(53.7%)和骨髓抑制14例(34.1%)，均屬可控范圍內(nèi)(Ⅰ～Ⅱ級(jí)); 其中37例(90.2%)獲得根治性切除，較常規(guī)手術(shù)組提高17.5% (P=0.041); ５年生存率為67.7%(21/31)，與常規(guī)手術(shù)組比較差異無(wú)統(tǒng)計(jì)學(xué)意義(χ2=0.517，P=0.471)。結(jié)論針對(duì)PGML患者，術(shù)前以CHOP方案行動(dòng)脈介入化療是安全、有效的，它能提高根治手術(shù)切除率，提高近期療效，但并不改善遠(yuǎn)期生存。

引用本文： 吳曉宇,姚學(xué)權(quán),陳徹,陳志偉,曹勤洪,翟兢,劉福坤. CHOP方案術(shù)前動(dòng)脈介入化療治療胃惡性淋巴瘤的回顧性臨床研究. 中國(guó)普外基礎(chǔ)與臨床雜志, 2011, 18(12): 1296-1300. doi: 復(fù)制

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2. Doglioni C, Ponzoni M, Ferreri AJ, et al. Gastric lymphoma: the histology report [J]. Dig Liver Dis, 2011, 43 Suppl 4: S310S318.
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6. 馬建輝. 重視實(shí)體瘤療效評(píng)價(jià)標(biāo)準(zhǔn)的變革RECIST概要 [J]. 中華泌尿外科雜志, 2006, 27(2): 7779.
7. Suzuki C, Jacobsson H, Hatschek T, et al. Radiologic measurements of tumor response to treatment: practical approaches and limitations [J]. Radiographics, 2008， 28(2): 329344.
8. 日本胃癌學(xué)會(huì)編. 胃癌取扱い規(guī)約 [M]. 第14 版. 東京: 金原出版, 2010: 155.
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10. Ghimire P, Wu GY, Zhu L. Primary gastrointestinal lymphoma [J]. World J Gastroenterol, 2011, 17(6): 697707.
11. Ferrucci PF, Zucca E. Primary gastric lymphoma pathogenesis and treatment: what has changed over the past 10 years? [J]. Br J Haematol, 2007, 136(4): 521538.
12. 張超, 姜軍, 阮圣興. 胃原發(fā)性惡性淋巴瘤的診斷與治療 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2002, 9(4): 269271.
13. Raderer M, Paul de Boer J. Role of chemotherapy in gastric MALT lymphoma, diffuse large Bcell lymphoma and other lymphomas [J]. Best Pract Res Clin Gastroenterol, 2010, 24(1): 1926.
14. 蔡兆輝, 于東風(fēng), 劉弋. 原發(fā)性胃淋巴瘤的臨床診斷和外科治療 [J]. 安徽醫(yī)科大學(xué)學(xué)報(bào), 2007, 42(5): 588590.
15. Parvez T, Behani A, Ali A. Primary gastric lymphoma [J]. J Coll Physicians Surg Pak, 2007, 17(1): 3640.
16. Wilke H, Preusser P, Fink U, et al. Preoperative chemotherapy in locally advanced and nonresectable gastric cancer: a phase Ⅱ study with etoposide, doxorubicin, and cisplatin [J]. J Clin Oncol, 1989, 7(9): 13181326.
17. Cunningham D, Allum WH, Stenning SP, et al. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer [J]. N Engl J Med, 2006, 355(1): 1120.
18. Barone C, Cassano A, Pozzo C, et al. Longterm followup of a pilot phase Ⅱ study with neoadjuvant epidoxorubicin, etoposide and cisplatin in gastric cancer [J]. Oncology, 2004, 67(1): 4853.
19. Kochi M, Fujii M, Kanamori N, et al. Neoadjuvant chemotherapy with S1 and CDDP in advanced gastric cancer [J]. J Cancer Res Clin Oncol, 2006, 132(12): 781785.
20. Mezhir JJ, Tang LH, Coit DG. Neoadjuvant therapy of locally advanced gastric cancer [J]. J Surg Oncol, 2010, 101(4): 305314.
21. 劉福坤, 李國(guó)立, 陳忠豪, 等. 胃癌術(shù)前介入治療的臨床和病理觀察(附250例報(bào)告) [J]. 南京大學(xué)學(xué)報(bào)(自然科學(xué)版), 1998, 34(2): 167171.
22. 劉福坤, 陳忠豪, 李國(guó)立, 等. 胃癌術(shù)前介入治療后血管變化與癌組織壞死的關(guān)系 [J]. 華人消化雜志, 1998, 6(8): 686688.
23. Li M, Zhang J, Wang D, et al. A phase Ⅱ study of intraarterial chemotherapy of 5fluorouracil, cisplatin, and mitomycin C for advanced nonresectable gastric cancer [J]. Anticancer Drugs, 2009, 20(10): 941945.
24. 劉福坤, 姚學(xué)權(quán). 胃癌的新輔助化療 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2006, 13(1): 1720.
25. Zhang CW, Zou SC, Shi D, et al. Clinical significance of preoperative regional intraarterial infusion chemotherapy for advanced gastric cancer [J]. World J Gastroenterol, 2004, 10(20): 30703072.
  1. 1. 胡建昆, 陳志新, 陳佳平, 等. 原發(fā)性胃惡性淋巴瘤的診斷和外科治療 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 1999, 6(3): 160161.
  2. 2. Doglioni C, Ponzoni M, Ferreri AJ, et al. Gastric lymphoma: the histology report [J]. Dig Liver Dis, 2011, 43 Suppl 4: S310S318.
  3. 3. Dawson IM, Cornes JS, Morson BC. Primary malignant lymphoid tumours of the intestinal tract. Report of 37 cases with a study of factors influencing prognosis [J]. Br J Surg, 1961, 49: 8089.
  4. 4. 孫燕, 石遠(yuǎn)凱. 臨床腫瘤內(nèi)科手冊(cè) [M]. 北京: 人民衛(wèi)生出版社, 2007: 142.
  5. 5. Therasse P, Arbuck SG, Eisenhauer EA, et al. New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada [J]. J Natl Cancer Inst, 2000, 92(3): 205216.
  6. 6. 馬建輝. 重視實(shí)體瘤療效評(píng)價(jià)標(biāo)準(zhǔn)的變革RECIST概要 [J]. 中華泌尿外科雜志, 2006, 27(2): 7779.
  7. 7. Suzuki C, Jacobsson H, Hatschek T, et al. Radiologic measurements of tumor response to treatment: practical approaches and limitations [J]. Radiographics, 2008， 28(2): 329344.
  8. 8. 日本胃癌學(xué)會(huì)編. 胃癌取扱い規(guī)約 [M]. 第14 版. 東京: 金原出版, 2010: 155.
  9. 9. 嚴(yán)慶漢. 惡性淋巴瘤的臨床分期//腫瘤病理診斷學(xué) [M]. 第2 版. 天津: 天津科學(xué)技術(shù)出版社, 1999: 345347.
  10. 10. Ghimire P, Wu GY, Zhu L. Primary gastrointestinal lymphoma [J]. World J Gastroenterol, 2011, 17(6): 697707.
  11. 11. Ferrucci PF, Zucca E. Primary gastric lymphoma pathogenesis and treatment: what has changed over the past 10 years? [J]. Br J Haematol, 2007, 136(4): 521538.
  12. 12. 張超, 姜軍, 阮圣興. 胃原發(fā)性惡性淋巴瘤的診斷與治療 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2002, 9(4): 269271.
  13. 13. Raderer M, Paul de Boer J. Role of chemotherapy in gastric MALT lymphoma, diffuse large Bcell lymphoma and other lymphomas [J]. Best Pract Res Clin Gastroenterol, 2010, 24(1): 1926.
  14. 14. 蔡兆輝, 于東風(fēng), 劉弋. 原發(fā)性胃淋巴瘤的臨床診斷和外科治療 [J]. 安徽醫(yī)科大學(xué)學(xué)報(bào), 2007, 42(5): 588590.
  15. 15. Parvez T, Behani A, Ali A. Primary gastric lymphoma [J]. J Coll Physicians Surg Pak, 2007, 17(1): 3640.
  16. 16. Wilke H, Preusser P, Fink U, et al. Preoperative chemotherapy in locally advanced and nonresectable gastric cancer: a phase Ⅱ study with etoposide, doxorubicin, and cisplatin [J]. J Clin Oncol, 1989, 7(9): 13181326.
  17. 17. Cunningham D, Allum WH, Stenning SP, et al. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer [J]. N Engl J Med, 2006, 355(1): 1120.
  18. 18. Barone C, Cassano A, Pozzo C, et al. Longterm followup of a pilot phase Ⅱ study with neoadjuvant epidoxorubicin, etoposide and cisplatin in gastric cancer [J]. Oncology, 2004, 67(1): 4853.
  19. 19. Kochi M, Fujii M, Kanamori N, et al. Neoadjuvant chemotherapy with S1 and CDDP in advanced gastric cancer [J]. J Cancer Res Clin Oncol, 2006, 132(12): 781785.
  20. 20. Mezhir JJ, Tang LH, Coit DG. Neoadjuvant therapy of locally advanced gastric cancer [J]. J Surg Oncol, 2010, 101(4): 305314.
  21. 21. 劉福坤, 李國(guó)立, 陳忠豪, 等. 胃癌術(shù)前介入治療的臨床和病理觀察(附250例報(bào)告) [J]. 南京大學(xué)學(xué)報(bào)(自然科學(xué)版), 1998, 34(2): 167171.
  22. 22. 劉福坤, 陳忠豪, 李國(guó)立, 等. 胃癌術(shù)前介入治療后血管變化與癌組織壞死的關(guān)系 [J]. 華人消化雜志, 1998, 6(8): 686688.
  23. 23. Li M, Zhang J, Wang D, et al. A phase Ⅱ study of intraarterial chemotherapy of 5fluorouracil, cisplatin, and mitomycin C for advanced nonresectable gastric cancer [J]. Anticancer Drugs, 2009, 20(10): 941945.
  24. 24. 劉福坤, 姚學(xué)權(quán). 胃癌的新輔助化療 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2006, 13(1): 1720.
  25. 25. Zhang CW, Zou SC, Shi D, et al. Clinical significance of preoperative regional intraarterial infusion chemotherapy for advanced gastric cancer [J]. World J Gastroenterol, 2004, 10(20): 30703072.