介入导管动脉化学药物治疗对直肠癌根治术后患者生存率的影响

The effect of intraarterial chemotherapy on long-term survival of patients after radical resection of rectal cardnoma

目的观察介入导管动脉化学药物治疗对直肠癌根治术后患者生存率的影响。方法采用介入导管动脉化学药物治疗(下称化疗)代替全身化疗治疗直肠癌根治术后患者56例。化疗药物为每次顺铂30～40mg/m^2、5-氟尿嘧啶500～750mg/m^2、丝裂霉索4～5mg/m^2。结果治疗后无大出血、肠坏死、肝肾功能障碍等严重并发症。经随访,治疗组1、2、3、4、5年的生存率分别是94.6%(53/56)、82.1%(46/56)、80.4%(45/56)、78.6%(44/56)和71.4%(40/56)。对照组1、2、3、4、5年的生存率分别是86.4%(38/44)、75.0%(33/44)、70.4%(31/44)、65.9%(29/44)和61.4%(27/44)。治疗组复发和转移率为32.1%(18/56),病死率28.6%(16/56)。对照组复发和转移率为47.7%(21/44),病死率为38.6%(17/44)。两组相比5年生存率、肿瘤的复发和转移率差异均有显著意义(P<0.01)。结论介入导管动脉化疗可明显提高直肠癌根治术后患者的5年生存率,降低肿瘤的复发率和转移率,副作用少,有望代替全身化疗。

Objective To evaluate the effect of intraarterial chemotheraphy on long-term survival rate of patients after radical resection of rectal carcinoma.Method Fifty-six patients undergoing radical resection for their rectal carcinoma were gien intraarterially chemotherapy consisting of DDP 30～40 mg/m^2,5-Fu 500～750 mg/m^2, MMC 4～5 mg/m^2.Result There were no serious complications in connection with intraarterial chemotherapy such as major colonic bleeding,bowl necrosis and hepatorenal malfunction.The 1,2,3,4,5 year's survival rate was 94.6%(53/56),82.1%(46/56),80.4%(45/56),78.6%(44/56)and 71.4%(40/56)respectively, while the survival rate for the control group was 86.4%(38/44),75.0%(33/44),70.5%(31/44),65.9% (29/44)and 61.4%(27/44),respectively.The patients 5 year's survival rate,recurrence and metastastic rate at 5 years were statistically superior to that in control group(P<0.01).Conclusion Postoperative intraarteri- al chemotherapy was better than traditional systemic chemotherapy in terms of 5 year's survival rate,tumor re- currence and metastasis control.