进展期结肠癌术后单纯静脉化疗和联合腹腔化疗方案的疗效比较  

Comparison of the Effect of Postoperative Intravenous Chemotherapy and Combined Intraperitoneal Chemotherapy for Advanced Colorectal Cancer

作　　者：章健[1] 胡强[1] 郑荣贵[1] 

机构地区：[1]上海市徐汇区中心医院普外科,上海200031

出　　处：《中国临床医学》2001年第4期375-377,共3页Chinese Journal of Clinical Medicine

摘　　要：目的 :比较进展期结肠癌术后单纯静脉较大剂量化疗和小剂量静脉化疗联合腹腔化疗 (intraperitonealchemotherapy ,IPC)的疗效。方法 :6 0例结肠癌术后分为静脉组 (30例 )及联合组 (30例 ) ,①静脉组 :采用 5 -FU0 .75 +CF0 .3第 1～ 5天 ,第1～ 3日分别加注入顺铂 40mg ,每月 1个疗程 ,共 6个疗程 ;②联合组 :静脉用 5 -FU0 .5 +CF0 .1第 1～ 5天 ,第 1～ 3天腹腔泵注入 5 -FU1.0 +顺铂 40～ 6 0mg ,每月 1个疗程 ,共 6个疗程。比较两组治疗的免疫功能变化、并发症、不良反应发生率、生存期的差异。结果 :①静脉组的DukesC1、C2、D期 ,患者腹腔癌肿生长率为 5 3.8% (7/ 13)、71.4% (10 / 14)、10 0 % (3/ 3) ,肝转移10例达 33.3% ,联合组的C1、C2、D期患者腹腔癌肿生长率 7.1% (1/ 14)、2 3 .1% (3/ 11)、10 0 % (3/ 3) ,肝转移 3例为 10 %。C1、C2期两组腹腔癌肿生长率有显著差别 (P <0 .0 5 ) ,肝转移率有显著差别 (P <0 .0 5 ) ;②联合化疗组前后T淋巴细胞免疫指标CD3+ 、CD4+ 、CD8+ 均未明显变化 ,静脉组化疗后CD3+ 、CD4+ 明显下降 ,CD8+ 略有增高 ;③联合组的粘连性肠梗阻发生率为 30 % (9/ 30 )、胃肠反应率 10 % (3/ 30 )、骨髓抑制率 2 0 % (6 / 30 ) ,静脉组分别是 3.3 % (1/ 30 )、80 %Objective: To compare curative effect of postoperative intravenous chemotherapy with that of combined intraperitoneal chemotherapy for advanced colorectal cancer. Methods: 60 postoperative patients with advanced colorectal cancer were divided into two groups. ①Intravenous group: 5-FU0.75+CF0.3 (d1～5),in addition to DDP40mg(d1～3);②Combined group:iv infusion of 5-FU0.75+CF0.3 (d1～5),IPC(d1～3) 5-FU1.0+DDP40～60mg, one episode each month,total six times. Results: ①Intravenous group: recurrence rate of intraperitoneal carcinoma in Dukes C1,C2,D were 53.8%(7/13),71.4%(10/14),100%(3/3) respectively,hepatic metastasis rate 33.3%;Combined group: recurrence rate of intraperitoneal carcinoma in Dukes C1,C2,D were 7.1%(1/14),23.1%(3/11),100%(3/3)respectively,hepatic metastasis rate 10% .②Combined group: CD3 +,CD4 +,CD8 + changed in small range;but intravenous group CD3 +,CD4 + declined obviously, CD8 + increased slightly. ③Combined group:intestinal obstruction 30%(9/30),voimt10%(3/30),marrow restrain20%(6/30);Vein group were3.3%(1/30),80%(24/30)and 63.3%(19/30)respectively.④Mortality56.7%(Intravenous group )or30% (Combined group) in two years, P <0.01. Conclusion: Change of immunity function, side-effect and recurrence rate of intraperitoneal carcinoma and hepatic metastasis rate, two-year mortality is lower in the combined group.

关 键 词：结肠癌 静脉化疗 腹腔化疗 药物联合治疗 

分 类 号：R735.35[医药卫生—肿瘤] R730.53[医药卫生—临床医学]