大肠癌术中植入氟尿嘧啶缓释剂安全性及其临床疗效的研究

Safety and its clinical curative effect of intra abdominal implantation of sustained releasing fluorouracil in patients with colorectal cancer

目的探讨大肠癌术中植入氟尿嘧啶(5-Fu)缓释剂的安全性及其临床疗效。方法158例直肠癌患者被随机分为A(植入组)、B(腹腔灌注组)和C(对照组)3组,A组采用手术+术中腹腔植入氟尿嘧啶缓释剂;B组采用手术+腹腔热灌注化疗;C组采用传统手术+化疗。比较3组术后并发症和首次化疗毒性反应以及3组2、5年生存率。结果 A组和B组并发症相当,对骨髓抑制和肝脏功能损害较C组轻;无论在2年还是5年无瘤生存率和总生存率A和B组差异无统计学意义,但是2年无病生存率均较C组高,差异具有统计学意义(P<0.05);3组在2年生存率、5年总无瘤生存率和5年总生存率均差异无统计学意义。结论大肠癌术中植入氟尿嘧啶缓释剂安全可靠,能降低2年复发率,但并不能提高近期和远期生存率。

Objective To study the safety and its clinical curative effect of intra abdominal implantation of sustained releasing fluorouracil. Methods One hundred and fifty-eight patients in the Department of First Pathology confirmed as II/III stage colorectal cancer were randomly divided into three groups, A （implantation group）, B （celiac infusion group） and C （control group）. Group A was given radical surgical operation ＋ intra abdominal implantation of sustained releasing fluorouracil; Group B radical surgical operation ＋ celiac hot infusion chemotherapy; Group C radical surgery ＋ traditional chemotherapy. The postoperative complications, first chemotherapy toxicity, 2-year and 5-year survival rate of the three groups were compared respectively. Results There were equivalent complications in Group A and B, their bone marrow suppression and liver function damage were lighter than Group C. There were no significant differences between the 2-year or 5-year disease-free and overall survival rate of Group A and B, but the disease-free survival rates of Group A and B were higher than that of Group C, with statistical significance, /0〈0.05. Three groups showed no significant difference in the 2-year overall survival rate, disease-free survival rate of 5-year and 5-year overall survival rate. Conclusion Intra abdominal implantation of sustained releasing fluorouracil is safe; it may reduce the 2-year recurrence, but can not improve immediate and long-term survival rate.