内镜下化疗粒子植入术治疗晚期直肠癌疗效评价(英文)

Chemotherapeutic seed implantation combined with stent placement for treatment of advanced rectal carcinoma: a case-control study

目的探讨内镜下化疗粒子植入术治疗晚期直肠癌的具体方案、治疗效果及安全性。方法将54例晚期直肠癌患者,分为四组:对症治疗组,口服希罗达化疗组,内镜下5-氟尿嘧啶(5-Fu)化疗粒子植入术组,口服化疗同化疗粒子植入术联合治疗组。知情同意后,分行不同的治疗方案,观察并分析抑瘤疗效,肠梗阻的发生率,1、2年生存率,治疗相关的不良反应及并发症。结果内镜下化疗粒子植入术能较好地被耐受,无明显不良反应及并发症发生。粒子植入术治疗后,直肠癌的临床受益患者达54.5%,接近口服化疗药物疗效58.8%,且粒子植入治疗组及联合口服化疗组中,肠梗阻的发生率明显降低(27.3%,20.0%)。较之对症治疗组,口服化疗组、粒子植入组及联合治疗组中直肠癌患者的2年生存率提高不明显(35.3%,36.4%,40.0%),但1年生存率(64.7%,63.6%,80.0%)有明显的提高。结论对于晚期直肠癌患者,内镜下化疗粒子植入术是一种操作简单、耐受性好、不良反应及并发症较少、具有一定疗效的治疗方法。

【Objective】To investigate the procedure,efficacy and safety of endoscopic implantation with anti-tumor drug seeds for the treatment of advanced rectal carcinoma【.Methods】With informed consent, 54 patients of advanced rectal carcinoma were enrolled to be randomly divided into 4 groups to receive respective treatment, including symptomatic treatment, oral chemotherapy with capecitabine, endoscopic 5-fluorouracil （5-Fu） seed implantation, or combination therapy with oral capecitabine and 5-Fu seed implantation. The inhibition of tumor grow, incidence of intestinal obstruction, 1-year or 2-year survival rate, adverse effects and complications in the groups with different treatments were observed and analyzed. 【Results】Endoscopic 5-Fu seed implantation was tolerated by patients without apparent adverse effects and complications. The objective response rate was 54.5% in 5-Fu seeds implantation group, close to 58.8% in oral chemotherapy group. Moreover, incidences of intestinal obstruction （27.3%, 20.0%） were significantly decreased in 5-Fu seed implantation group and combination therapy group. Compared to the symptomatic treatment group, 2-year survival rates （35.3%, 36.4%, 40.0%） were not significantly improved in oral chemotherapy, 5-Fu seed implantation and combination treatment groups, but 1-year survival rates （64.7%, 63.6%, 80.0%） were significantly elevated. 【Conclusion】Endoscopic anti-tumor drug seed implantation is a convenient, better-tolerated, efficacious treatment for advanced rectal carcinoma patients with few adverse effects and complications.