晚期直肠癌术前介入栓塞化疗与静脉途径新辅助化疗的对比研究

Comparative study on preoperative interventional chemoembolization and intravenous neoadjuvant chemotherapy for treating advanced rectal carcinoma

目的探讨术前介入栓塞化疗在晚期直肠癌治疗中的应用价值。方法选择该院2007年7月至2011年7月收治的晚期直肠癌患者57例,随机分为对照组27例,行静脉途径新辅助化疗结合手术治疗。实验组30例,行介入栓塞化疗结合手术治疗,比较两组患者的疗效。结果实验组消化道症状(53.3%),肝、肾功能损害(13.3%),神经毒性(20.0%),骨髓抑制(23.3%),手足综合征(0.0%)的不良反应低于对照组(分别为88.9%、51.9%、70.4%、66.7%、11.1%),P<0.05;实验组患者手术根治性切除率(90.0%)、保肛率(76.7%)均高于对照组(分别为59.3%,44.4%),P<0.05。结论晚期直肠癌术前介入栓塞化疗不良反应轻,能明显提高手术根治性切除率及保肛率,是一种安全有效的新辅助化疗措施。

Objective To analyze the application value of preoperative interventional chemoembolization for the treatment of advanced rectal carcinoma.Methods The clinical data in 57 cases of advanced rectal carcinoma in our hospital from July 2007 to July 2011 were selected and divided into the study group（30 cases） undergone operation after preoperative interventional chemoembolization and the control group（27 cases） undergone operation after intravenous neoadjuvant chemotherapy.The clinical effects were analyzed and compared between the two groups.Results The digestive tract symptoms,lesion of liver and renal functions,neurotoxicity,myelosuppression and handfoot syndrome were 53.3%,13.3%,20.0%,23.3% and 0.0% in the study group and 88.9%,51.9%,70.4%,66.7% and 11.1% in the control group,showing that the rates of adverse reactions in the study group was significantly lower than those in the control group（P〈0.05）.The rates of operative radical resection and the rates of sphincter-preserving were 90.0% and 76.7% in the study group,which were higher than 59.3% and 44.4% in the control group（P〈0.05）.Conclusion Preoperative interventional chemoembolization is a safe and effective neoadjuvant chemotherapy measure for treating advanced rectal carcinoma with less adverse reactions,which can obviously increase the rate of operative radical resection and the sphincter-preserving rate.