氟尿嘧啶缓释化疗粒子在预防直肠癌术后复发的应用研究

Clinical Study of Implanting 5-Fluorouracil Sustained-release to Prevent Local Recurrence of Rectal Cancer

【目的】探讨氟尿嘧啶缓释化疗粒子在预防直肠癌术后复发的临床效果。【方法】选择直肠癌根治手术患者96例,随机分成对照组(Ⅰ组)和治疗组(Ⅱ组),Ⅰ组45例均行全直肠系膜切除,其中Dixon术35例,Miles术10例,Ⅱ组51例实行全直肠系膜切除,另加手术剥离面植入氟尿嘧啶缓释化疗粒子,其中Dixon术38例,Miles术13例,术后两组于21周后复查血常规,统计Dixon术后吻合口瘘的发生率,随访术后6个月、12个月、24个月肿瘤局部复发率。【结果】术后2周血常规均在正常范围,两组病例中行Dixon术者吻合瘘分别只有2例发生。治疗组术后6个月、12个月、24个月的肿瘤局部复发率分别为:0%、3.9%、11.8%而对照组分别为:11.1%、20%、35.6%,两组比较有显著差异(P<0.05)。【结论】应用氟尿嘧啶缓释化疗粒子对预防直肠癌术后复发有一定意义,且方法简便,不增加手术后吻合口瘘发生的风险。

To evaluate the clinical effect of implanting 5-Fluorouracil（5Fu） Sustained-release （SR） in preventing local recurrence after operation of rectal cancer. [Methods] Ninety six patients with rectal cancer undergoing total mesorectal excision were randomly divided into 2 groups. The patients in experiment group were implanted with 5Fu Sustained-release to dissected regions at the time of operation of total mesorectal excision （51 cases, including Miles 13 cases and Dixon 38 cases）. 45 patients, as control group, underwent operation alone （including Miles 10 cases and Dixon 35 cases）. [Results]All patients were examined routinely blood after two weeks, and the results were normal. Complications of anastomotic fistula were in 2 cases of the two groups respectively. In the experiment group, the 6-, 12-, 24-month local recurrence rates were 0 %, 3.9 % and 11.8%, compared with 11.1%, 20.0 % and 35.6 % in control group（all P 〈0.05）. [Conclusion]The implanting 5Fu-SR might become a new hopeful method to prevent postoperative local recurrence of rectal cancer.