不可切除的结肠癌肝转移辅助化疗后手术切除66例

SIXTY-SIX CASES OF SURGERY RESECTION OF UNRESECTABLE LIVER METASTASES FROM COLON CANCER AFTER ADJUVANT CHEMOTHERAPY

目的探讨不可切除的结肠癌肝转移在接受辅助化疗后行手术切除的临床疗效。方法 2008年2月—2010年2月共收治不可切除的结肠癌肝转移患者66例,将患者接受新辅助化疗后,化疗效果评定为肿瘤完全消失+肿瘤消退50%的患者作为治疗组;将效果评定为无变化+肿瘤进展的患者作为对照组。所有患者均进行新辅助化疗即经肝动脉导管注入奥沙利铂、亚叶酸钙、5-氟尿嘧啶3种化疗药物;治疗组在对患者影像学资料重新评估后进行手术切除治疗。观察所有患者的化疗总有效率及手术切除率,并比较2组患者的生存时间。结果化疗总有效率为59.1%,手术切除率为51.5%;治疗组患者的生存时间明显高于对照组(P<0.05)。结论对不可行手术切除的结肠癌肝转移患者进行术前新辅助化疗后,可明显提高患者手术切除的几率,是治疗不可切除的肝转移患者的有效措施。

Objective To investigate the clinical efficacy of surgical re：section of unresectable liver metastases from colon cancer after adjuvant chemotherapy. Metlhods Sixty - six patients with unresectable liver metastases from colon cancer were treated from February 2008 to February 2010, the patients received chemotherapy and assessed CR ＋ PR were considered as the treament groups while the patients assessed SD ＋ PD were considered as the control group. All of the patients were given new adjuvant chemotherapy that injected oxaliplatin （L- OHP）, leucovorin （CF） ,5 -fluorouracil （5 -FU） by hepatic artery. In the treatment group, the imaging data was reassessed and the patients were given the surgical resection. The total efficiency of chemotherapy, surgical resection rate, and survival time of the patients were compared between the two groups. Results The total effective rate, of chemotherapy was 59.1%, the surgical resection rate was 51.5 % ; the survival time in the treatment group was significantly higher than the control group （ P 〈 0.05 ）. Conclusion The new adjuvant chemotherapy to unresectable liver metastases of colon cancer can significantly increase the chance of hepateclomy, and improve the cure rate, and it is an effective measure for patients with unresectable liver metastases from colon cancer.