肿瘤细胞减灭术加腹腔热灌注化疗治疗结直肠癌腹膜转移癌的临床研究  

Clinical study of cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy in treating patients with peritoneal carcinomatosis from colorectal cancer

作　　者：韦世壮[1] 刘锦新[1] 冯关荣[1] 黄海[1] 朱茂光[1] 孙兴[1] 苏泽[1] 韦昭懿[1] 

机构地区：[1]南宁市第一人民医院普通外科,广西530022

出　　处：《中国临床新医学》2014年第7期611-614,共4页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

摘　　要：目的探讨肿瘤细胞减灭术(CRS)加腹腔热灌注化疗(HIPEC)治疗结直肠癌腹膜转移癌(CRC PC)的疗效及安全性。方法选取结直肠癌腹膜转移癌(CRC PC)患者67例,随机分为治疗组(CRS+HIPEC)38例,对照组(CRS+静脉辅助化疗)29例,比较两组的生存期、生存率、术后并发症及化疗毒副作用。结果治疗组中位生存期23.0个月,显著长于对照组的11.0个月(P<0.01),治疗组1、2、3年生存率分别为70.9%、45.7%、8.2%,分别优于对照组的68.8%、21.2%、0%。术后并发症发生率两组相似(P>0.05)。化疗毒副作用:对照组恶心呕吐、白细胞减少、血小板减少发生率较治疗组高(P<0.01),而治疗组腹胀、腹泻发生率较对照组高(P<0.01或P<0.05);两组其他毒副作用相似(P>0.05)。结论 CRS+HIPEC治疗CRC PC能明显延长患者生存期,并发症和化疗毒副作用并没有明显增加。Objective To evaluate the efficacy and safety of cytoreductive surgery （CRS） combined with hyperthermic intraperitoneal chemotherapy （ HIPEC） in treating patients with peritoneal carcinomatosis （ PC） from colorectal cancer（CRC）.Methods A total of 67 CRC PC were divided into two group：therapeutics group（n=38, CRS＋HIPEC） and control group（n=29, CRS and systemic adjuvant chemotherapy ）.Overall median survival,survival rate, adverse reaction were compared .Results Therapeutic group had a significantly better overall median survival when compared to control group （23.0 months vs.11.0 months）（P〈0.01）.The 1-, 2-and 3-year survival rate of therapeutic group were 70.9%,45.7%and 8.2%, respectively, superior to those of control group （68.8%,21.2%and 0%） .Two group had a similar postoperative complication rate （ P〉0.05 ） .Chemotherapy toxic effects：control group had higher incidence rate in nausea and vomiting , leucopenia , thrombocytopenia （ P〈0.01 ） while therapeutic group higher in abdominal distension and diarrhea （ P〈0.01 or P〈0.05 ） .Two group had similar incidence rate in hypoproteinemia , hepatic and renal insufficiency , respiratory tract infections , hyperbilirubinemia （ P〉0.05 ） .Conclusion The CRS＋HIPEC method can greatly improve the survival of patients with PC from CRC while doesn′t significantly increase postoperative complication rate and chemotherapy toxic effects .

关 键 词：结直肠癌 腹膜转移癌 肿瘤细胞减灭术 腹腔热灌注化疗 

分 类 号：R735[医药卫生—肿瘤]