胃肠道癌根治术后辅助区域性化疗的临床效果分析

Therapeutic Effect of Regional Postoperative Chemotherapy for Gastrointestinal Cancer Following Total Correction

目的:探讨区域性置管化疗泵对预防胃肠道癌根治术后局部复发和肝脏转移的意义。方法:对治疗组600例中的122例结直肠癌采用门静脉置管,478例胃癌中304例经胃左动脉近心端置管,174例经门静脉置管,导管连接化疗泵体埋于皮下,术后第3天开始经化疗泵给予表柔比星、丝裂霉素、氟尿嘧啶化疗。对照组经外周静脉行全身化疗。结果:1、3和5年生存率,治疗组分别为100.0%、82.0%和53.3%,对照组分别为84.1%、45.4%和32.0%;局部复发率和肝脏转移率治疗组分别为6.3%和7.0%,对照组分别为28.0%和25.9%,化疗期间肝脏损害发生率高于对照组,两组各项指标比较均有非常显著性差异(P<0.01)。结论:胃肠道癌根治术后区域性置管皮下埋藏化疗泵化疗效果优于全身静脉化疗,化疗过程中要注意保护肝脏功能。

Objective ：To explore the significance of the postoperative regional chemotherapy in preventing local recurrence and hepatic metastasis after radical resection of gastrointestinal cancer. Methods：The study group contained 122 cases of rectacolonal cancer and 478 case of gastric cancer. The patients with rectacolonal cancer were cathetered through portal vein;304 cases of gastric cancer were cathetered through gastric sinistral artery and the rest 174 cases through port vein. The catheters in all patients were connected to pumps and put subcutaneouly. Chemotherapy with epirudicin, MMC and FU was administrated 3 days after the operation via the pumps, while 600 patients in control group were given systemic chemotherapy via peripheral vein. Results：The patients＇l-year,3-year and 5-year surrvial rates in the study group were 100.0% ,82.0% and 53.3% , respectively, but in the control group the parameters were 84.1% ,45.4% and 32.0% , respectively. The local recurrence rate and hepatic metastasis rate in the study group were 6.3% and 7.0% , while in the control group they were 28.0% and 25.9% , respectively ; the incidence of hpeatic lesion in study group was more frequent than in controt group. There was a significant difference in each of the above parameters between the two groups （P 〈 0.01 ）. Conclusion ：The regional chemotherapy through the pumps and catheter embedded subcutaneouly was superior to the systemic chemotherapy for treatment of gastroinstestinal cancer after radical resection.