腹腔恒温热灌注联合静脉化疗治疗Ⅱ～Ⅲ期直肠癌术后患者的临床疗效

Clinical Observation of Homothermal Peritoneal Hot-perfusion Chemotherapy and Intravenous Chemotherapy for Stage Ⅱ～Ⅲ Rectal Cancer

目的分析腹腔恒温热灌注联合静脉化疗治疗腹腔镜直肠癌根治术后患者的临床疗效。方法回顾性分析58例直肠癌患者的临床资料,根据化疗方式分为单纯全身静脉化疗组(对照组)28例及腹腔恒温热灌注+全身静脉化疗组(实验组)30例。比较两组患者术后恢复情况、临床总有效率、化疗不良反应等方面的差异。结果两组患者术后恢复情况、化疗不良反应及并发症发生率等方面比较均无统计学差异(P>0.05),而实验组治疗后临床总有效率(83.3%)明显高于对照组(71.4%),且局部复发率(3.3%)及远处转移率(6.7%)显著低于对照组(21.4%,28.6%),而1年生存率(96.7%)明显高于对照组(78.6%),差异均具有统计学意义(P<O.05)。结论腹腔镜下直肠癌根治术后辅以腹腔恒温热灌注联合静脉化疗,可以提高患者的1年生存率,降低局部复发及转移率,同时不加重患者化疗毒副反应,且不影响患者术后恢复情况,是一种安全有效的治疗手段,值得临床大力推广。

Objective To explore the therapeutic efficacy of homothermal peritoneal hot-perfusion chemotherapy with intravenous chemotherapy for stage Ⅱ ~ Ⅲ rectal cancer. Methods Clinical data of 58 cases of rectal cancer were retrospectively analyzed. 58 cases of advanced rectal cancer were divided into HIPEC group（ n = 30） and the control group（ n = 28）. After radical resection,HIPEC combined with the FOLFOX6 chemotherapy plan was the experiment grou. The control group received FOLFOX6 chemotherapy plan only. Indicators related to postoperative recovery、clinical efficacy rate and the adverse reactions of chemotherapy of the 2 groups were compared. Results The differences of postoperative recovery,adverse reactions of chemotherapy and the incidence of complications of the 2 groups had no statistical significance（ P〈0. 05）. In the experiment group,the clinical efficacy rate（ 83. 3%） was higher than the control group（ 71. 4%）,and the local recurrence and distant metastasis rate of the experiment group was lower than the control group（ 3. 3% vs 21. 4%,6. 7% vs 28. 6%,P〈0. 05）,1-year survival rate of the experiment group（ 96. 7%） was higher than the control group（ 78. 6%）（ P〈0. 05）. Conclusion Combination of homothermal peritoneal hot-perfusion chemotherapy with intravenous chemotherapy does not increase complications and adverse reaction of chemotherapy,however,it can decrease the rate of postoperative intraperitoneal recurrence and metastasis,improve the prognosis of patients,thus it is worthy of promoting.