预防性腹腔热灌注化疗治疗结直肠癌的临床研究  

Clinical study of prophylactic hyperthermic intraperitoneal chemotherapy for colorectal cancer

作　　者：李福 任宝清 郭晨媛 黄博[1] Fu Li;Baoqing Ren;Chenyuan Guo;Bo Huang(Department of Hepatobiliary and Pancreatic Surgery,Shanxi Provincial People's Hospital,Taiyuan 030000,China;Department of Gastrointestinal Surgery,Shanxi Provincial People's Hospital,Taiyuan 030000,China;Department of Cardiology,Shanxi Coal Center Hospital,Taiyuan 030000,China)

机构地区：[1]山西省人民医院肝胆胰病区,太原市030000 [2]山西省人民医院胃肠外科,太原市030000 [3]山西省煤炭中心医院心血管内科

出　　处：《中国肿瘤临床》2024年第24期1267-1272,共6页Chinese Journal of Clinical Oncology

基　　金：山西省科技厅自然科学研究面上项目(编号:202303021221227)资助。

摘　　要：目的:探究预防性腹腔热灌注化疗(hyperthermic intraperitoneal chemotherapy,HIPEC)对结直肠癌(colorectal cancer,CRC)患者的安全性和有效性。方法:回顾性收集山西省人民医院2019年2月至2022年2月180例CRC患者的临床资料,分成HIPEC组(n=53)和对照组(n=127),其中HIPEC组53例,对照组127例。采用1∶1比例进行倾向得分匹配(propensity score matching,PSM)来平衡两组间的混杂因素,成功匹配到48对患者,分析两组患者术后并发症的发生和早期转移情况。结果:HIPEC组与对照组在术后并发症发生方面比较差异无统计学意义(P>0.05)。随访显示两组患者术前术后CEA有明显下降(P<0.05)。CRC术后早期的总体转移率为17.65%,HIPEC组与对照组术后早期总体转移率差异具有统计学意义(9.30%vs.26.19%,P<0.05)。结论:CRC术中行HIPEC是安全、可行的,不增加术后并发症的发生。洛铂作为灌注液无明显不良反应。术中HIPEC可有效预防CRC术后的早期转移,有利于患者的预后。Objective:To study the safety and efficacy of prophylactic hyperthermic intraperitoneal chemotherapy(HIPEC)in patients with colorectal cancer(CRC).Methods:The data of 180 patients with CRC at Shanxi Provincial People's Hospital from February 2019 to February 2022 were retrospectively collected and assigned into HIPEC and control groups.Among these patients,53 patients were in the HIPEC group and 127 patients were in the control group.Proensity score matching(PSM)using 1:1 ratio to balance the confounding factors between the two groups and successfully matched to 48 pairs of patients.Results:No significant difference was observed in the occurrence of postoperative complications between the HIPEC and control groups(P>0.05).After 2 years of follow-up,a significant decrease was noted in preoperative and postoperative carcinoembryonic antigen(CEA)levels in both groups(P<0.05).The overall metastasis rate for early postoperative CRC was 17.65%,which differed significantly between the HIPEC and control groups(9.30%vs.26.19%,P<0.05).Conclusions:HIPEC is safe and feasible for CRC surgery and does not increase the occurrence of postoperative complications.As a perfusion solution,lobaplatin exhibits minimal toxicity and no apparent side effects.Intraoperative HIPEC can effectively prevent early metastasis of CRC,which is conducive to improved patient prognosis.

关 键 词：结直肠癌 腹腔热灌注化疗 洛铂 转移 

分 类 号：R735.34[医药卫生—肿瘤]