进展期结直肠癌术中洛铂腹腔灌注化疗的临床疗效及安全性分析

Clinical efficacy and safety of intraperitoneal chemotherapy with lobaplatin in advanced colorectal cancer

目的探讨洛铂腹腔灌注化疗在进展期结直肠癌术中应用的临床疗效及安全性。方法选择2019年7月至2020年11月在云浮市人民医院接受治疗的66例进展期结直肠癌患者进行研究,按照随机数表法分为研究组(n=32)和对照组(n=34),对照组采用结直肠癌根治术治疗,研究组采用结直肠癌根治术联合洛铂腹腔灌注化疗治疗。化疗结束一个月后,比较两组患者的客观缓解率(ORR)、胃肠功能;于术前一周和化疗结束后次日,比较两组患者血细胞计数、血尿素氮、谷丙转氨酶(ALT)水平;评估患者治疗3个月后短期生活质量及术后不良反应发生情况。结果治疗后,研究组患者的ORR为90.62%,明显高于对照组的61.76%,差异有统计学意义(P<0.05);治疗后,两组患者的胃肠功能比较差异无统计学意义(P>0.05);两组患者治疗前的白细胞计数、血红蛋白、血小板计数比较差异均无统计学意义(P>0.05);治疗后,研究组患者的白细胞计数、血红蛋白、血小板计数水平分别为(5.49±0.97)×10^(9)/L、(139.02±3.70)g/L、(102.97±4.61)×10^(9)/L,明显高于对照组的(4.23±1.02)×10^(9)/L、(107.75±6.37)g/L、(89.56±7.37)×10^(9)/L,差异均有统计学意义(P<0.05);两组患者治疗前的血尿素氮、ALT水平比较差异均无统计学意义(P>0.05);治疗后,两组患者的血尿素氮、ALT水平较治疗前明显升高,差异均有统计学意义(P<0.05),但两组间比较差异无统计学意义(P>0.05);治疗后,研究组患者的整体功能、角色功能、情绪功能、认知功能、社会功能及总生存质量评分明显高于对照组,差异均有统计学意义(P<0.05);研究组和对照组患者的不良反应发生率分别为25.00%、14.71%,差异无统计学意义(P>0.05)。结论洛铂腹腔灌注化疗治疗进展期结直肠癌可有效改善患者的临床症状,不会增加术后毒副反应,提高患者的生活质量,临床治疗效果确切。

Objective To investigate the clinical efficacy and safety of intraperitoneal chemotherapy with lobaplatin in the operation of advanced colorectal cancer.Methods Sixty-six patients with advanced colorectal cancer who received treatment in Yunfu People's Hospital from July 2019 to November 2020 were selected for the study.According to the random number table,the patents were divided into the study group(n=32)and the control group(n=34).The control group was treated with radical resection of colorectal cancer,and the study group was treated with radical resection of colorectal cancer combined with intraperitoneal chemotherapy with lobaplatin.The objective remission rate(ORR)and gastrointestinal function of the two groups were compared one month after chemotherapy.One week before operation and the next day after chemotherapy,the blood cell count,blood urea nitrogen,and alanine aminotransferase(ALT)levels of the two groups were analyzed and compared.The short-term quality of life and postoperative adverse reactions were evaluated after 3 months of treatment.Results After treatment,the ORR of the study group was 90.62%,which was significantly higher than 61.76%in the control group(P<0.05).After treatment,there was no significant difference in gastrointestinal function between the two groups(P>0.05).There was no significant difference in white blood cell count,hemoglobin,and platelet count between the two groups before treatment(P>0.05).After treatment,the white blood cell count,hemoglobin,platelet count levels of the study group were(5.49±0.97)×10^(9)/L,(139.02±3.70)g/L,(102.97±4.61)×10^(9)/L,which were significantly higher than(4.23±1.02)×10^(9)/L,(107.75±6.37)g/L,(89.56±7.37)×10^(9)/L in the control group(P<0.05).There was no significant difference in blood urea nitrogen and ALT levels between the two groups before treatment(P>0.05).After treatment,the levels of blood urea nitrogen and ALT in the two groups were significantly higher than those before treatment(P<0.05),but there was no significant difference between the two groups(P>0.05).After treatment,the scores of overall function,role function,emotional function,cognitive function,social function,and total quality of life in the study group were significantly higher than those in the control group(P<0.05).The incidence of adverse reactions in the study group and the control group were 25.00%and 14.71%,and the difference was not statistically significant(P>0.05).Conclusion Intraperitoneal chemotherapy with lobaplatin can effectively improve the clinical symptoms of patients with advanced colorectal cancer,which does not increase postoperative toxicity and improves the quality of life of patients.