术中局部使用氟尿嘧啶缓释剂治疗局部进展期结肠癌

Intraoperative intraperitoneal chemotherapy with sustained-release 5-fluorouracil for treatment of locally advanced colon cancer

目的探讨术中局部植入氟尿嘧啶缓释剂(5-Fu SRI)对局部进展期结肠癌的治疗作用。方法对70例局部进展期(T4N0M0及Ⅲ期)结肠癌患者行根治性手术,分为治疗组(n=36):术中局部植入5-Fu SRI 600 mg;对照组(n=34):术中以氟尿嘧啶注射液1 000 mg冲洗腹腔。两组患者术后化疗方案相同。回顾性分析两组患者的局部复发和远处转移例数以及2年生存率。结果治疗组的2年生存率和局部复发率均优于对照组(P<0.05);两组远处转移率比较,差异无统计学意义(P>0.05)。结论术中局部植入5-Fu SRI可降低术后局部复发率,并可提高2年生存率。

Objective To evaluate the effects of intraoperative intraperitoneal chemotherapy with sustained release 5-fluorouracil for implantation （5-Fu SRI） for the treatment of locally advanced colon cancer. Methods A total of 70 patients with locally advanced primary colon cancer （T4 N0 M0 and stage Ⅲ ） undergoing radical resection were divided into treatment group（ n = 36, intraoperative intraperitoneal chemotherapy with 600 mg 5-Fu SRI） and control group（ n = 34, intraoperative intraperitoneal flushing with 1 000 mg 5-fluorouracil injection）. Both groups received the same postoperative chemotherapy regime. The 2-year survival rate, local recurrence rate and distant metastasis rate were retrospectively analysed. Results The 2-year survival rate and local recurrence rate were more favourable in treatment group than those in control group（P 〈 0. 05）, while there was no significant difference in distant metastasis rate between these two groups （P 〉0.05）. Conclusion Intraoperative intraperitoneal chemotherapy with 5-Fu SRI may decrease postoperative local recurrence rate and increase 2-year survival rate.