进展期结直肠癌根治术后腹腔热灌注化疗联合全身化疗的临床相关性研究  

Intraperitoneal hyperthermic perfusion chemotherapy combined with systemic chemotherapy in the treatment of advanced colorectal cancer-the clinical analysis

作　　者：张日雄[1] 吴祖光[1] 李恩[1] 刘宏涛[1] 陈楷[1] 张灼新[1] 曾海敬[1] 李志旺[1] ZHANG Rixiong WU ZUguang LIEn LIU Hongtao CHEN Kai ZHANG Zhuoxin ZENG Haijing LI Zhiwang(Department of Gastroenterology Surgery, Meizhou People＇s Hospital, Meizhou , Guangdong 514031, China.)

机构地区：[1]梅州市人民医院胃肠外一科,广东梅州514031

出　　处：《岭南现代临床外科》2017年第1期39-42,共4页Lingnan Modern Clinics in Surgery

摘　　要：目的评估进展期结直肠癌患者在行腹腔镜下根治性切除术后采取腹腔热灌注化疗联合全身化疗的临床疗效及安全性。方法选择两组在我院收治的78例进展期结直肠癌患者,一组为联合化疗组(39例),在行腹腔镜下结直肠癌根治性切除术后,首先行腹腔热灌注化疗(IHIPC)3次,然后再采用全身化疗,方案为(XELOX);另一组为单一化疗组(39例),在行腹腔镜下结直肠癌根治性切除术后,单纯采用全身化疗,方案为(XELOX)。对两组患者的临床疗效及安全性进行对比分析。结果联合化疗组患者在化疗后,其KPS评分升高率为53.85%,单一化疗组在化疗后,其KPS评分升高率为25.64%,两者差异存在统计学意义(P<0.05);两组患者的各种不良反应发生率无明显差异(P>0.05);对两组患者术后随访5年,联合化疗组的患者在第1、3、5年的生存率分别为94.87%、84.62%、69.23%,单一化疗组分别为92.31%、64.10%、46.15%,两组患者在第3、5年的生存率进行比较,其差异存在统计学意义(P<0.05)。结论进展期结直肠癌患者在行腹腔镜下根治性切除术后采取腹腔热灌注化疗联合全身化疗,可能提高了患者的术后生存质量及生存率,且不良反应也无明显增加。Objective To investigate the clinical efficacy and adverse reaction by implement ofabdominal hot perfusion chemotherapy on advanced colorectal cancer after laparoscopic radical resection.Methods Seven-eight cases of advanced colorectal cancer patients were recruited and assigned to twogroups,39 cases in each group. The patients in combined chemotherapy group underwent laparoscopicradical colorectal cancer resection combined with intraperitoneal hyperthermic chemotherapy（IPHC）for 3times after surgery,then received the conventional systemic chemotherapy（XELOX）,and those in singlechemotherapy group were performed systemic chemotherapy alone in 4 weeks after laparoscopic radicalcolorectal cancer resection. The clinical efficacy and safety were evaluated in patients of two groups. KPSscore,adverse reaction,survival rate were recorded and analyzed. Results The KPS score increased at arate of 53.85% in combined chemotherapy group,and 25.64% in single chemotherapy group. Thedifference between two groups had statistical significance（P〈0.05）. There was no difference between twogroups in incidence of the adverse reaction. The 1-year,3-year and 5-year survival rates were respectively 92.31%,64.10% and 46.15%. The 3-year and 5-year survival rates were rising when compared with singlechemotherapy group（all P values less than 0.05）. Conclusion For advanced colorectal cancer patients,IPHC supplementation based on systemic chemotherapy generally provides improvement in survival afterlaparoscopic radical resection,and had less adverse reactions during chemotherapy.

关 键 词：进展期结直肠癌 腹腔热灌注化疗 联合化疗 全身化疗 

分 类 号：R657.1[医药卫生—外科学]