细胞减灭术加腹腔热灌注化疗治疗结直肠癌腹膜转移癌病例对照研究  

Cytoreductive surgery and hyperthermic intraperitoneal chemo therapy improve survival of patients with peritoneal carcinomato sis from colorectal cancer: a retrospective case-control study

作　　者：黄超群[1] 周云峰[1] 谢丛华[1] 杨肖军[1] 程伏林[1] 熊斌[1] 杨国樑[1] 李雁[1] 

机构地区：[1]武汉大学中南医院肿瘤科,湖北省肿瘤医学临床研究中心,肿瘤生物学行为湖北省重点实验室,武汉市430071

出　　处：《中国肿瘤临床》2013年第16期979-983,共5页Chinese Journal of Clinical Oncology

基　　金：国家自然科学基金创新群体项目(编号:20921062);中央高校基本科研业务费专项资金资助(编号:2012303020212);教育部博士学科点专项科研基金(编号:20120141110042)资助~~

摘　　要：目的：分析细胞减灭术（cRs）加术中腹腔热灌注化疗术（HIPEC）对结直肠癌腹膜转移癌的疗效及安全性。方法：课题设计为回顾性病例对照研究，收集结直肠癌腹膜转移癌（CRCPC）患者资料，按临床病理参数匹配原则，分为CRS组（CRS＋术后全身化疗）29例，HIPEC组（CRS＋HIPEC＋术后全身化疗）33例。分析两组的总体生存期（os）及严重不良事件（SAE）。结果：两组患者临床病理学特征均衡可比，术中PCI评分及器官，腹膜切除情况相似。两组中位随访时间分别为41．9个月（6．5～110．0个月）和32．0个月（10．5～95．9个月），OS分别为8．5个月（95％CI：4．9—12．1个月）和14．5个月（95％CI：11．9～17．1月）（P=0．007）。术后30天内CRS组3例发生SAE，HIPEC组9例（P=0．126）。多因素分析显示，HIPEC、CC0～1分、术后化疗周期≥6个周期为改善生存的独立预后因素。结论：CRS＋HIPEC可改善CRCPC患者生存期，SAE无显著增加，安全性可接受。Objective： To evaluate the efficacy and safety of cytoreductive surgery （CRS） in conjunction with hyperthermic intra- peritoneal chemotherapy （HIPEC） for treating patients with peritoneal carcinomatosis （PC） from colorectal cancer （CRC）. Methods： A total of 62 CRC patients with complication of PC were divided into the CRS group, namely, Group One （n=29, CRS and systemic adju- vant chemotherapy） and the CRS ＋ HIPEC group, namely, Group Two （n=33, CRS＋HIPEC）. The primary end point of the study was overall survival （OS） and the secondary end point was serious adverse events （SAE）. Results： Patients＇ clinicopathologic characteris- tics, peritoneal carcinomatosis index, and completeness of cytoreduction therapy were well balanced and comparable between the two groups. The median follow-up was 41.9 mo （6.5 mo to 110.0 too） in Group One and 32.0 mo （10.5 mo to 95.9 mo） in Group Two. The median OS was 8.5 mo （95% CI： 4.9 mo to 12.1 mo） in Group One and 14.5 mo （95% CI： 11.9 mo to 17.1 mo） in Group Two （P= 0.007）. Within 30 days after the surgery, SAE occurred in 3 of the 29 patients in Group One, and 9 of the 33 patients in Group Two （P= 0.126）. Multivariate analysis revealed that HIPEC, CC0-1 score, and chemotherapy over six cycles were the independent factors for OS improvement. Conclusion： The CRS＋HIPEC method improves the OS of patients with PC from CRC, suggesting an acceptable safety.

关 键 词：结直肠癌 细胞减灭术 腹腔热灌注化疗 腹膜癌 

分 类 号：R735.3[医药卫生—肿瘤]