大肠腺癌5-FU门静脉插管化疗临床研究

Chemotherapeutic effect of 5-fluorouracil by port vein infusion for patients with colorectal adenocarcinoma

目的 探讨 5 - FU门静脉插管 (port vein infusion,PVI)化疗对大肠腺癌患者的疗效 .方法 将 97例大肠腺癌患者 ,随机双盲分为根治性切除加门静脉化疗组 (治疗组 )和单纯根治性切除术组 (对照组 ) ;对照组住院期间不辅助化疗 ,治疗组在根治术后立即行门静脉插管化疗 ,术后第 1日开始每天持续滴注 5 - FU 1g,肝素 5 0 0 0 U / 10 0 0 m L ,共 7d.两组患者出院后系统辅助化疗相同 ,随访 5 a,观察患者术后转移及生存情况 .结果 治疗组肝转移发生率明显低于对照组(15 .4 % ,36 .4 % ,P<0 .0 5 ) ,其术后 3a生存率 (84 .4 % ,6 0 .4 % ,P<0 .0 5 )、5 a生存率 (71.1% ,5 1.1% ,P<0 .0 5 )显著高于对照组 ,术后局部复发率及其他器官转移率无明显差异 ,两组术后并发症发生率、住院时间无明显差异 .结论 对大肠腺癌患者术后进行门静脉化疗可安全有效地降低肝转移发生率 ,提高生存率 .

AIM To determine the chemotherapeutic effect of 5 fluorouracil (5 FU) by port vein infusion (PVI) on the patients with colorectal adenocarcinoma. METHODS Patients were randomly divided into 2 groups. The study group received 5 FU and heparin chemotherapy by PVI immediately (5 FU 1.0 g·heparin 5000 u·L -1 ·d -1 , continuing for 7d), and the control group did not receive any chemotherapy, after radical resection. All patients were followed. RESULTS The rate of liver metastasis was lower(15.4%,36.4%, P <0.05). The three year overall survival (84.4%,60.4%, P <0.05) and the five year overall survival rate (71.1%, 51.1% , P <0.05) were higher in the study group than that in control group. No statistically significant difference was observed between two groups in incidence of complication. CONCLUSION 5 Fu chemotherapy by PVI after radical resection in the patients with colorectal cancer may decrease the liver metastasis rate and increase the overall survival rate, without a significant increase in incidence of complication.