Complete mesocolic excision combined with arterial infusion and intra-peritoneal interstitial sustained-release chemotherapies for colorectal cancer
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摘要:
目的 探讨CME联合术中动脉灌注及腹腔内间质缓释剂化疗的安全性及疗效。 方法 选取行CME联合术中动脉灌注并腹腔内间质缓释剂化疗的结肠癌患者104例为试验组，98例行结肠癌根治术患者为对照组。检测患者术前、术后血常规、肝肾功能，记录术后不良反应、并发症发生率。检测试验组癌组织、癌旁组织、术后引流液以及外周血5-FU浓度。随访3年，记录两组患者局部复发率、肝脏转移率、无疾病进展生存率及总生存率。 结果 两组术前、术后血常规、肝肾功能，术后不良反应、并发症发生率无显著性差异（P>0.05）。试验组癌组织中5-FU浓度明显高于癌旁组织。试验组患者术后第3天腹腔内引流液5-FU浓度显著升高，同时外周血5-FU浓度达到峰值。试验组淋巴结转移率、肝脏转移率、无疾病进展生存率及3年总生存率均明显优于对照组，差异具有统计学意义（P < 0.05）。 结论 试验组患者的治疗安全有效，明显提高无疾病进展生存率和3年总生存率，且能显著降低结肠癌的淋巴结转移率和肝脏转移率。 Abstract:Objective To investigate the safety and effect of complete mesocolie excision (CME) combined with arterial infusion chemotherapy (AIC) and intra-peritoneal interstitial sustained-release chemotherapy (IPISRC). Methods A total of 104 patients were classified under the experimental group and underwent CME combined with AIC and IPISRC. The other 98 patients were classified under the control group and only received radical surgery. Pre- and post-operative blood routine examinations, as well as liver and kidney function tests, were conducted for both groups. Post-operative adverse reactions and incidence of complications were recorded. Cancer and para-neoplastic tissues were sampled in experimental group. The post-surgery 5-fluorouracil (5-FU) concentration in the drainage fluid as well as those in the peripheral blood, were determined. Three-year follow-ups were conducted, during which the local recurrence rate, liver metastasis, progression-free survival rate, and total survival rate were recorded. Results No significant differences were found in the white blood cell count, hemoglobin count, liver and renal functions of the patients before and after the surgery, and rate of adverse reaction and complications between the two groups after surgery (P>0.05). In experimental group, the 5-FU concentration was significantly higher in the cancer tissues than in the para-neoplastic tissues. The 5-FU concentration in experimental group was also significantly higher in the intra-peritoneal drainage liquid and reached its peak in the peripheral blood on day 3 post-surgery. Local recurrence and liver metastasis rates were significantly lower in experimental group than those in control group, whereas the progression-free and three-year overall survival rates were significantly higher in experimental group than in control group (P < 0.05). Conclusion The tharepy of pations of experimental goup is safe and effective. This method significantly improves the progression-free and three-year survival rates of the patients as well as significantly reduces the local recurrence and liver metastasis rates of colon cancer. -
图 1 试验组和对照组患者3年OS及DFS对比
A：Three-year OS of the two groups；B：The 3-year DFS of the two groups
Figure 1. Comparison of DFS and the 3-year OS rate curves between the test and control groups
表 1 试验组和对照组患者一般资料
Table 1. Basic data of patients in the test group and the control group
表 2 试验组和对照组患者局部复发率、肝脏转移率、3年生存率、无疾病进展生存率比较结果
Table 2. Comparison of local recurrence and liver metastasis rates, as well as the 3-year overall survival(OS)and disease-free survival(DFS) rates between the test and control groups
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