目的：观察并探讨局部热疗联合奥沙利铂（L-OHP）、多西紫杉醇（DXL）、5-氟尿嘧啶（5-FU）治疗晚期胃癌的临床疗效。方法入选2009年9月-2011年10月住院的进展期胃癌患者85例，随机分为观察组（44例）与对照组（41例）。对照组患者给予L-OHP＋DXL＋5-FU 4周期化疗方案，观察组在此基础上同步给予局部热疗，化疗结束后随访24个月，对比2组近期疗效与24个月生存率。结果（1）化疗结束后2个月，观察组总有效率（79．5％）、临床获益率（95．5％）、KPS评分（77．5±5．2）分均高于对照组的61．0％、85．4％、（75．2±5．5）分，且KPS评分差异有统计学意义（ P ＜0．05）。（2）2组化疗期间主要药物毒性反应类型及发生率相近，差异无统计学意义（P ＞0．05）。（3）观察组与对照组化疗后24个月生存率（43．2％vs．34．2％），差异无统计学意义（χ2＝0．730， P ＝0．393），平均生存时间分别为20．068（95％CI 19．764～20．373）个月、18．767（95％CI 18．379～19．155）个月，累积生存概率分别为（0．547±0．017）、（0．477±0．019），差异均具有统计学意义（ t ＝25．878， P ＝0．000；χ2＝19．926， P ＝0．000）。结论进展期胃癌化疗基础上联合局部热疗能发挥协同作用，提高带瘤生活质量，延长患者生存时间。%Objective To explore the clinical efficacy of local hyperthermia combined with oxaliplatin (L-OHP), do-cetaxel (DXL) and 5 fluorouracil (5-FU) in the treatment of advanced gastric cancer .Methods Selected from 2009 Septem-ber to 2011 October hospitalized patients of gastric cancer (85 cases), they were randomly divided into observation group (44 cases) and control group (41 cases).Patients in the control group treated by L-OHP+DXL+5 FU with 4 cycles of chemo-therapy, the observation group based on the same chemotherapy , meanwhile synchronous give local thermotherapy , after thera-py, follow-up 24 months, compared the 2 groups'curative effect and 24 months survival rate .Results (1) 2 months after the end of chemotherapy, the observation group total effective rate was 79.5%,clinical benefit rate was 95.5%,KPS score was (77.5 ±5.2)points,these indexes were higher than that of the control group [61.0%,85.4%and (75.2 ±5.5)points],and there was significant difference in KPS score ( P <0.05).(2) During the chemotherapy, drug toxicity type and occurrence of the 2 group were similar;there was no significant difference ( P >0.05).(3) The observation group and the control group's 24 months after chemotherapy survival rate were 43.2%and 34.2%respectively, no significant difference were found (χ2 =0.730, P =0.393), the average survival time was 20.068 (95%CI 19.764-20.373) months, 18.767 (95%CI 18.379-19.155) months, the cumulative survival probabilities were 0.547 ±0.017 and 0.477 ±0.019 respectively, the differences were statistically significant ( t =25.878, P =0.000,χ2 =19.926, P =0.000).Conclusion Combination of local hyper-thermia and L-OHP+DXL+5-FU regimen in treatment of advanced gastric cancer can play a synergistic role in improving life quality with tumor , and prolonging the survival durations .
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