结直肠癌术后腹腔热灌注联合全身化疗的疗效观察(1)
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【摘要】 目的 观察结直肠癌术后腹腔热灌注联合全身化疗的疗效及不良反应。方法 将我科2000-03—2003-01收治的50例T4病变结直肠癌术后患者采用信封法随机分为腹腔热灌注联合全身化疗的治疗组26例和单纯行全身化疗的对照组24例,观察两组患者腹腔复发率、肝转移率及1年、3年、5年生存率。结果 治疗组腹腔复发率及肝转移率明显低于对照组(23.1%vs 50.0%,15.4%vs 41.7%,P<0.05),治疗组1年、3年及5年的生存率明显高于对照组(92.3%vs 91.7%,69.2%vs 50.0%,38.5%vs 20.8%,P<0.05)。两组严重不良反应比较差异无统计学意义(P>0.05)。结论 本研究提示T4病变结直肠癌术后腹腔热灌注联合全身化疗,能有效降低术后腹腔复发及肝转移,而且提高患者的生存率,不良反应能够耐受。
【关键词】 结直肠癌;局部灌注;全身化疗
【Abstract】 Objective To observe the effect of chemotherapeutic hyperthermic intraperitoneal perfusion combined with general chemotherapy in treatment of postoperative coloretal cancer.Methods 50 patients with T4 stages of colorectal carcinoma after surgery from Mar.2000 to Jan.2003 were enrolled.Using sealed envelope methodand,all patinets were randomly diveded into treatment group(n=26) and control group(n=24).The treatment group was treated with chemotherapeutic hyperthermic intraperitoneal perfusion combined with general chemotherapy and the control group was treated with general chemotherapy alone.The incidence of peritoneal recurrence and liver metastasis,and 1,3,5 year survival rate of each group were analyzed.Results The incidence of peritoneal recurrence and liver metastasis in the treatment group were significantly lower than those in the control group(23.1%vs 50.0%,15.4%vs 41.7%,P<0.05),the 1,3 and 5 year-survival rates were also significantly higher than those in the control group(92.3%vs 91.7%,69.2%vs 50.0%,38.5%vs 20.8%,P<0.05).There was no significant difference of the main adverse reaction between the two groups.Conclusion chemotherapeutic hyperthermic intraperitoneal perfusion combined with general chemotherapy is effective in reducing incidence of peritoneal recurrence and liver metastasis and increasing survival rate of coloretal cancer, with tolerable side effect.
【Key words】 Colorectal carcinoma;Regional perfusion;General chemotherapy
结直肠癌浸润浆膜层后往往发生肉眼或镜下的腹膜播散种植,而结直肠癌的门静脉转移甚至可发生Dukes A期,结直肠癌腹膜播散种植和肝转移是术后复发和转移的重要原因,即使采用D4廓清手术都不能清除潜在的癌细胞腹膜和门静脉播散[1-5]。近年来腹腔内热灌注化疗被应用于晚期结直肠癌的术后辅助治疗,但对其疗效的报道存在较大差异,且目前尚缺乏联合应用生物制剂灌注的相关报道 ......
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