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腹腔热灌注化疗用于进展期结直肠癌术后辅助治疗的临床观察

宋林杰 那兴邦 李松岩 张红亮 杨宇 杜晓辉

解放军医学院学报2017,Vol.38Issue(12):1098-1101,4.
解放军医学院学报2017,Vol.38Issue(12):1098-1101,4.DOI:10.3969/j.issn.2095-5227.2017.12.002

腹腔热灌注化疗用于进展期结直肠癌术后辅助治疗的临床观察

Clinical observation of postoperative hyperthermic intraperitoneal chemotherapy for patients with progressive colorectal cancer

宋林杰 1那兴邦 2李松岩 1张红亮 2杨宇 1杜晓辉1

作者信息

  • 1. 解放军总医院 普通外科,北京 100853
  • 2. 南开大学 医学院,天津 300071
  • 折叠

摘要

Abstract

Objective To study the safety and efficacy of postoperative hyperthermic intraperitoneal chemotherapy in patients with progressive colorectal cancer.Methods Clinical data about 143 cases with progressive colorectal cancer underwent surgery in department of general surgery of Chinese PLA General Hospital from July 2013 to July 2014 were reviewed.Patients were randomly divided into observation group (n=72) and control group (n=71).Patients in observation group received hyperthermic intraperitoneal chemotherapy combined with conventional intravenous chemotherapy,while patients in control group only received intravenous chemotherapy.The incidences of adverse reaction of chemotherapy and postoperative complications,3-year overall survival and metastatic recurrence in patients of the two groups were compared.Results There was no statistically significant difference between the two groups in gender,age,primary tumor location,tumor infiltration depth,lymphatic metastasis,TNM staging,and pathological type.The incidences of adverse reaction of chemotherapy in observation group,including gastrointestinal reaction (Ⅰ-Ⅱ 41.7%,Ⅲ-Ⅳ 13.9%),bone marrow suppression (Ⅰ-Ⅱ 33.3%,Ⅲ-Ⅳ 19.4%),liver function injury (Ⅰ-Ⅱ 38.9%,Ⅲ-Ⅳ 18.1%),were slightly higher than those of control group (Ⅰ-Ⅱ 39.4%,Ⅲ-Ⅳ 15.5%;Ⅰ-Ⅱ 26.8%,Ⅲ-Ⅳ 15.5%;Ⅰ-Ⅱ 36.6%,Ⅲ-Ⅳ 15.5%,all P < 0.05).Complications in observation group,including bleeding,which was slightly lower than that of control group (9.7% vs 9.9%),while leakage and fistula (9.7%),abdominal cavity infection (13.9%),intestinal obstruction (11.1%) were slightly higher than those of control group (8.5%,11.3%,8.5%),but no statistical difference was found.The 1-year,2-year,3-year recurrence metastasis rates of observation group were 2.8%,6.9%,9.7%,and they were less than those of control group (11.2%,15.5%,21.1%) without significant difference.The 1-year,2-year,3-year survival rates of the observation group were 90.3%,80.6%,70.8%,lower than those of control group (80.3%,64.8%,54.9%),and the differences were statistically significant (All P < 0.05).Conclusion Compared with traditional intravenous chemotherapy,postoperative hyperthermic intraperitoneal chemotherapy combined with intravenous chemotherapy can reduce the recurrence rate and prolong the survival of patients with progressivecolorectal cancer.

关键词

结直肠癌/腹腔热灌注/静脉化疗/不良反应/生存期

Key words

colorectal cancer/hyperthermic intraperitoneal chemotherapy/intravenous chemotherapy/adverse reactions/survival time

分类

医药卫生

引用本文复制引用

宋林杰,那兴邦,李松岩,张红亮,杨宇,杜晓辉..腹腔热灌注化疗用于进展期结直肠癌术后辅助治疗的临床观察[J].解放军医学院学报,2017,38(12):1098-1101,4.

基金项目

国家自然科学基金项目(61471397)Supported by the Natural Science Foundation of China (61471397) (61471397)

解放军医学院学报

OACSTPCD

2095-5227

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