植入用缓释氟尿嘧啶腹腔化疗在结直肠癌术中应用的临床研究

Clinical research of intraperitoneal chemotherapy with fluorouracil sustained-release implant in colorectal cancer

目的评估植入用缓释氟尿嘧啶腹腔化疗在Ⅱ、Ⅲ期结直肠癌术中应用的疗效和安全性。方法标准结直肠癌根治性切除术后的Ⅱ、Ⅲ期结直肠癌患者108例,分为腹腔植入缓释氟尿嘧啶组35例和对照组73例(常规处理),腹腔植入组在根治性手术过程中术野植入缓释氟尿嘧啶,对照组仅行常规处理,两组患者术后按NCCN指南进行诊疗。比较两组患者围手术期局部并发症、化疗毒副反应以及2年内复发转移情况和2年无病生存率。结果两组患者围手术期局部并发症和化疗毒副反应无统计学差异(P>0.05)。随访24个月至51个月,2年无病生存率比较,腹腔植入组为85.71%,对照组为60.27%,差异有统计学意义(P<0.05)。2年复发转移率比较,腹腔植入组为14.29%,对照组为39.73%,差异有统计学意义。腹腔植入组2年总生存率为94.3%,高于对照组83.6%,但差异未达统计学差异。结论植入用缓释氟尿嘧啶腹腔化疗在Ⅱ、Ⅲ期结直肠癌术中应用安全有效,在2年内复发转移以及2年无病生存率方面,具有明显优势。

Objective To evaluate the efficacy and safety of intraperitoneal chemotherapy with fluorouracil sustained-release implant in stage Ⅱand Ⅲ colorectal cancers.Methods One hundred and eight patients with stage Ⅱ or Ⅲ colorectal cancer were divided into intra-peritoneal implantation chemotherapy group (n=35) and control group (n=73).Intra-peritoneal implantation chemotherapy group received implantation of fluorouracil sustained-release implant in the surgical fields after digestive continuity reconstruction,while the control group only received routine management during radical operation.Peri-operative local complications,adverse events,local recurrence and metastasis,and 2-year disease-free survival were compared between the two groups.Results There were no significant differences in peri-operative local complications and adverse events between the two groups(P>0.05).The 2-year disease-free survival (DFS) rate in intra-peritoneal implantation chemotherapy group was 85.71%,significantly higher than 60.27% in the control group(P<0.05).The 2-year recurrence and metastasis rate was 14.29% in intra-peritoneal implantation chemotherapy group,39.73% in the control group(P<0.05).The 2-year overall survival (OS) rate was 94.3% in implantation chemotherapy group,higher than 83.6% in the control group,but no significance was found.Conclusion Intraperitoneal chemotherapy with fluorouracil sustained-release implant in colorectal cancer is safe and effective with obvious superiority in control of local recurrence and metastasis,and 2-year disease-free survival rate.