5-氟尿嘧啶缓释剂间质化疗在结直肠癌根治术中的应用效果和安全性观察

Efficacy and Safety of Interstitial Chemotherapy with 5-Fluorouracil Sustained Release Agent in Radical Operation of Colorectal Cancer

目的观察5-氟尿嘧啶缓释剂间质化疗在结直肠癌根治术中应用的效果和安全性。方法将2011年10月至2013年12月期间入我科行结直肠癌根治术的160例患者作为研究对象。用不完全随机方法将160例行结直肠癌根治术患者随机分成观察组(78例)和对照组(82例)。2组患者均行结直肠癌根治术,术后冲洗腹腔和盆腔;观察组术中植入5-氟尿嘧啶缓释剂进行间质化疗,植入部位为肿瘤切除区域及肠系膜动脉周围;术后2组患者均行常规化疗。观察2组患者术后并发症情况、术后局部复发率、肝转移率及术后24个月时的生存率。结果观察组和对照组患者在腹腔相关并发症及药物毒副作用发生率方面比较差异均无统计学意义(P>0.05)。观察组患者术后12个月和24个月复发率分别为1.3%(1/78)和5.2%(4/78),分别明显低于对照组的8.5%(7/82)和23.2%(19/82),差异均有统计学意义(x^2=8.934,P=0.023;x2=14.834,P=0.004)。观察组肝转移率为10.3%(8/78),明显低于对照组的18.3%(15/82),差异有统计学意义(x^2=12.034,P=0.016);观察组术后24个月时的生存率为94.9%(74/78),明显高于对照组的84.1%(69/82),差异有统计学意义(x^2=11.465,P=0.010)。结论 5-氟尿嘧啶缓释剂间质化疗安全性高,可有效降低结直肠癌根治术后的复发率和肝转移率,延长患者生存时间。

Objective To observe effect and safety of interstitial chemotherapy with 5-fluorouracil sustained release agent in radical operation of colorectal cancer. Methods One hundred and sixty patients with colorectal cancer from October 2011 to December 2013 were randomly divided into observation group and control group according to an incomplete random method, 78 cases of them were in the observation group and 82 cases of them were in the control group. All the patients were performed radical resection of colorectal cancer. The abdominal cavity and pelvic cavity were washed after surgery. 5-fluorouracil sustained release agent was implanted in the observation group patients for interstitial chemotherapy, the implant site was at the tumor resection area and the mesenteric artery. Routine chemotherapy was performed in these two groups after operation. The postoperative complications were observed. The postoperative local recurrence rate, liver metastasis rate, and 24-month survival rate were recorded. Results The rates of abdominal complications and toxic effects had no significant differences between these two groups （P〉0.05）. The rates of 12-month and 24-month local recurrence and the rate of liver metastasis in the observation group were significant lower than those in the control group [ 1.3% （1/78） versus 8.5% （7/82）, x2=8.934, P=0.023; 5.2% （4/78） versus 23.2% （19/82）, x2=14.834, P=0.004; 10.3% （8/78） versus 18.3% （15/82）, x2=12.034, P=0.016]. The rate of 24-month survival in the observa- tion group was significant higher than that in the control group [94.9% （74/78） versus 84.1% （69/82）, x2= 11.465, P=0.010 Conclusion The good safety of interstitial chemotherapy with 5-fluorouracil sustained release agent could effectivelydecrease local recurrence rate and liver metastasis rate of colorectal cancer after radical operation and improve survival time of patients.