局部进展期直肠癌术前全身静脉联合区域动脉灌注化疗栓塞的疗效评价  

Efficacy of preoperative systemic vein chemotherapy combined with regional intraarterial chemoembolization in the management of locally advanced rectal cancer

作　　者：郜永顺[1] 钱国武[1] 张云飞[1] 吴刚[2] 李甸源[3] 李文才[4] 赵武干[4] 赵阳阳[4] 

机构地区：[1]郑州大学第一附属医院胃肠外科,河南省郑州市450052 [2]郑州大学第一附属医院介入科,河南省郑州市450052 [3]郑州大学第一附属医院放疗科,河南省郑州市450052 [4]郑州大学第一附属医院病理科,河南省郑州市450052

出　　处：《世界华人消化杂志》2013年第4期367-372,共6页World Chinese Journal of Digestology

摘　　要：目的:评价局部进展期直肠癌术前全身静脉联合区域动脉灌注化疗栓塞的有效性和安全性.方法:对郑州大学第一附属医院自2008-01/2012-07收治的320例接受新辅助治疗后行经腹手术切除的局部进展期直肠癌的临床资料进行回顾性分析.其中术前全身静脉联合区域动脉灌注化疗栓塞者148例(A组),术前放疗+化疗者组172例(B组),休息3-4wk后手术.比较分析两组术后组织病理学疗效、不良反应发生率及术后并发症发生率.结果:所有术后标本组织病理学评估均有效,A组的疗效满意率高于B组(60.81%vs45.35%,P<0.05);不良反应(除外恶心反应)和术后吻合口瘘、肠梗阻及切口愈合不良等并发症发生率均低于B组(均P<0.05),而恶心反应发生率高于B组(χ2=31.16,P<0.001);两组均无新辅助治疗相关死亡病例.结论:局部进展期直肠癌术前全身静脉联合区域动脉灌注化疗并栓塞的疗效确切,可降低不良反应、术后并发症发生率.AIM：To evaluate the effectiveness and safety of preoperative systemic vein chemotherapy combined with regional intra-arterial chemoembolization in the management of locally advanced rectal cancer.METHODS：Clinical data for 320 patients with locally advanced rectal cancer treated at the First Affiliated Hospital of Zhengzhou University from January 2008 to July 2012 were retrospective.The patients were divided into two groups,patients who received preoperative systemic vein chemotherapy combined with regional intra-arterial chemoembolization（group A,n=148） and those who received preoperative radiotherapy combined with chemotherapy（group B,n=172）.All cases involved in this study were treated with neoadjuvant therapy followed by anterior resection 3 to 4 weeks later.The overall effective rate,the incidence of adverse reactions and postoperative complications were compared between the two groups.RESULTS：All patients had surgical specimens eligible for histopathological assessment.The overall satisfaction rate was signif icantly higher in group A than in group B（57.6% vs 44.8%,P0.05）.The incidence of adverse reactions（except nausea） and postoperative complications such as anastomotic leakage,intestinal obstruction and poor wound healing were all lower in group A than in group B（all P0.05）,while the incidence of nausea was higher in group A（χ2=31.16,P0.001）.There was no perioperative mortality related to neoadjuvant therapy in both groups.CONCLUSION：Preoperative systemic vein chemotherapy combined with regional intra-arterial chemoembolization is associated with better eff icacy and fewer adverse reactions and postoperative complications in the management of locally advanced rectal cancer.

关 键 词：直肠肿瘤 放化疗 新辅助疗法 化学疗法 肿瘤 局部灌注 

分 类 号：R735.37[医药卫生—肿瘤]