经门静脉和肝动脉灌注化疗治疗不可切除的结直肠癌肝转移的临床研究

A Clinical Trial of Portal Vein and Hepatic Artery Perfusion Chemotherapy for the Treatment of Patients with Unresectable Liver Metastasis from Colorectal Cancer

[目的]探讨不可切除的结直肠癌肝转移患者的治疗方法。[方法]97例不可切除的结直肠癌肝转移患者分为治疗组47例和对照组50例。对照组结直肠癌切除术后2周开始FOLFOX方案全身化疗。治疗组在结直肠癌切除术中及术后经门静脉和肝动脉化疗泵行5-Fu肝脏局部灌注化疗,全身化疗和其余治疗同对照组。[结果 ]两组治疗后病灶数目和大小均减小,CEA、CA199均降低,两组差异显著(P<0.05)。治疗组中位生存时间33.7个月,1、3、5年生存率分别为81.2%、42.8%和10.6%,对照组中位生存时间21.8个月,1、3、5年生存率分别为64.0%、19.7%和0,两组差异显著(P<0.05);两组术后并发症及不良反应发生率无明显差异(P>0.05)。[结论]经门静脉和肝动脉灌注化疗对于不可切除的结直肠癌肝转移瘤是安全有效的,可以延长患者的生存期,改善患者预后。

[ Purpose ] To investigate treatment method for patients with unresectable liver metastasis from colorectal cancer. [Methods ] Ninety-seven cases with unresectable liver metastasis from colorectal cancer were divided into 2 groups：47 cases in treatment group and 50 cases in control group. FOLFOX chemotherapy was given after two weeks post-colorectomy for patients in control and treatment group. The patients in treatment group received 5-Fu perfusion chemotherapy via portal vein and hepatic artery intraopertion and postoperation of colorectomy. [Results] The number and size of lesions,and levels of CEA and CA199 were decreased both in the two groups, which were significantly different between the 2 groups （P〈0.05）. The median survival was 33.7 months and 1-,3-,5-year survival rates were 81.2% ,42.8% ,10.6% respectively in treatment group,while those were 21.8 months,64.0%, 19.7% ,0 respectively in control group,with significant difference between the 2 groups （P〈0.05）.But the postoperative complications and toxicities were similar between the 2 groups （P〉0.05）. [ Conclusion]Perfusion chemotherapy via portal vein and hepatic artery for patients with unresectable liver metastasis from colorectal cancer is safe and effective, and it may prolong the survival and improve the prognosis of the patients.