腹腔大容积化疗预防大肠癌术后腹腔及肝转移的研究

Prevention of the Postoperative Metastasis of Liver and Peritonium in Colorectal Cancer by a Great Volume of Intraperitoneal Chemotherapy

目的 研究腹腔大容积化疗预防大肠癌术后腹腔复发及肝转移的效果。方法 自 1995年 6月～ 1999年 12月将大肠癌术后患者分成 2组 :A组 5 5例采用经埋藏式化疗泵行大容积腹腔化疗 ,B组 43例行常规静脉化疗 (CF/ 5 Fu方案 ) ,比较两者术后肝及腹腔复发的发生率、发生时间及术后存活时间。结果 A组 5 5例中 ,有 2例于术后 9、15个月出现腹腔复发 ,2例于术后13、16个月出现肝转移 ,发生率为 8.3 % ,5 1例 (92 .7% )未见转移 ,平均存活时间为 32个月。B组术后 3～ 14个月分别有 5例出现肝转移和 6例出现腹腔复发 ,发生率为 2 5 .6 % ,32例 (74.4% )未见转移 ,平均存活时间为 2 0个月。结论 早期腹腔大容积化疗预防大肠癌术后腹腔内复发、肝转移有明显的疗效 ,且方法安全、简单、实用。

Objective To evaluate the effection of prevention from the postoperative metastasis of liver and peritoneal recurrence of colorectal cancer by a great volume of intraperitoneal chemotherapy(IPC).Methods From June,1995 to December,1999,the postoperative cases of colorectal cancer were divided into Group A(55 cases) and Group B(43 cases),group A was treated by a great volume of IPC,group B was treated by routine intravenous chemotherapy(CF/5-Fu),and then the incidences of postoperative metastasis of liver and peritonium,times of metastasis and survival in two groups were compared.Results In group A,2 cases of liver metastasis occured in 9 and 15 months postoperation,2 cases of peritoneal metastasis in 13 and 16 months.The incidence of metastasis was 8.3%.In group B,5 cases of liver metastasis and 6 cases of peritoneal metastasis occured in 3～14 months postoperation,the incidence was 25.6%.The average survival time in two groups was 32(group A) and 20 months(group B) respectively.Conclusion The early postoperactive IPC is effective in preventing tumour recurrence in peritoneal cavity and metastatis of liver in patients with colorectal cancer,this procedure is simple、safe and practical.