三泵化疗预防直肠癌术后局部复发及肝转移的研究

Three pump chemotherapy in preventing postoperative local recurrence and hepatic metastasis of rectal carcinoma

目的探讨双侧髂内动脉加门静脉置泵化学治疗（三泵化疗）预防直肠癌根治术后局部复发和肝脏转移的价值。方法回顾性总结直肠癌根治术１４６例患者采用三泵化疗（Ⅰ组）４４例，单侧髂内动脉加门静脉置泵化疗（Ⅱ组）５０例，全身化疗（Ⅲ组）５２例，均行５氟脲嘧啶加丝裂霉素Ｃ化疗方案。结果ＤｕｋｅｓＣ期患者：Ⅰ组３年生存率、局部复发率、肝转移率分别为８２１％、１０７％、７１％，Ⅲ组为４３３％、５０％和３６７％，两组分别相比差异均有显著意义（Ｐ＜００１）。Ⅱ组局部复发率（４０６％）与Ⅰ组（１０７％）相比差异有显著意义（Ｐ＜００１）。结论三泵化疗效果优于全身化疗，双侧髂内动脉置泵化疗优于单侧髂内动脉置泵化疗。

Objective To evaluate the value of bilateral internal iliac artery (BIIA) and portal vein pump implantation chemotherapy(three pump chemotherapy,TPC) in preventing local recurrence and hepatic metastasis after radical operation of rectal carcinoma.Method 146 patients with rectal carcimoma operated on were retrospectively studied and divided into three groups:The TPC group (Group Ⅰ,44 cases),unilateral interral iliac artery and portal vein pump implantation chemotherapy group (UNIAP) (Group Ⅱ,50 cases),and peripheral vein chemotherapy group (Group Ⅲ,52 cases). Chemotherapy program of 5 fluorouracil and mitomycin C was adopted in all the three groups.Results In the cases of Dukes C stage,the rate of the three year survival,local recurrence,and hepatic metastasis for Group Ⅰ were 82 1%, 10 7%, and 7 1% respectively,while for Group Ⅲ were 43 3%, 50%, and 36 7% respectively.The differences between the two groups were all statislically significant ( P <0 01).The difference of local recurrence between Group Ⅰ ( 10 7%) and Group Ⅱ (40 6%) was very significant ( P <0 01).Conclusion The efficacy of TPC is superior to peripheral vein chemotherapy,also TPC is superior to that of UNIAP in terms of preventing local recurrence.