门静脉持续化疗联合腹腔大容积化疗预防大肠癌术后肝转移的研究

Prevention of the Postoperative Metastasis of Liver in Colorectal Cancer by Port al Vein Continuous Chemotherapy and Great Volume of Intraperitoneal Chemotherapy

目的研究门静脉持续化疗联合腹腔大容积化疗预防大肠癌术后肝转移的效果.方法对104例临床无显示肝转移大肠癌且能行根治术患者随机分为实验组(A)和对照组(B),A组53例术中放置皮下门静脉和腹腔化疗泵,并于术后使用5-Fu门静脉持续化疗和腹腔大容积化疗各6个疗程,B组51例行常规静脉化疗(CF/5-Fu方案),亦为6个疗程,对全部病例随访,比较两组术后肝转移发生率发生时间和术后存活时间.结果A组术后1、2、3、4年肝转移为1例(1.9%)、2例(3.8%)、4例(7.5%)、3例(5.7%),生存率为52/53(98.1%)、50/52(96.2%)、46/50(92.0%)、39/46(84.8%).B组术后1、2、3、4年肝转移为3例(5.9%)、6例(11.8%)、8例(15.7%)、5例(9.8%),生存率46/51(90.2%)、40/46(86.9%)、30/40(75.9%)、18/30(60.0%).结论门静脉持续化疗联合腹腔大容积化疗可明显减少大肠癌手术后肝转移的发生,增加生存率,是预防大肠癌术后肝转移的良好治疗方法.

Objective To evaluate the effection of prevention from the postoperative metastasis of liver in colorectal cancer by portal vein continuous chemotherapy and great volume of intraperitoneal chemotherapy. Methods From January, 1998 to December, 2002, the postoperative cases of colorectal cancer were divided into Group A（53cases） and Group B（51cases） ,group A was treated by portal vein continuous chemotherapy and great volume of intraperitoneal chemotherapy, group B was treated by routine intravenous chemotherapy（ CF/5 - Fu）, and then the incidences of postoperative metastasis of liver, times of metastasis and survival in tow groups were compared. Results In group A, the incidences of postoperative metastasis of liver was 1（ 1.9% ） ,2（3.8% ）4（7.5% ） 3（5. 7% ） and survival was 52/53（98.1% ） ,50/52（96.2% ）46/50（92.0% ） 39/46（84.8% ） in 1,2,3,4year,In group B, the incidences of postoperative metastasis of liver was 3（5.9% ） ,6（ 11.8% ） ,8（ 15.7% ） ,5（9.8% ） and survival was,46/51 （90.2%） ,40/ 46（86.9% ）,30/40（75.9% ）,18/30（60.0% ） in 1,2,3,4year. Conclusions The portal vein continuous chemotherapy and great volume of intraperitoneal chemotherapy is effective in preventing postoperative metastasis of liver in colorectal cancer.