腹腔内灌注结合静脉给药双路化疗法治疗晚期大肠癌的疗效观察

Intraperitoneal Infusion Combined with Intravenous Chemotherapy for The Treatment of Patients with Advanced Colorectal Carcinoma

目的 :比较双路化疗法与静脉单路化疗法治疗晚期大肠癌的疗效及毒副反应。方法 :1996年 3月至2 0 0 2年 8月间 ,我科采用随机对照方法 ,将 89例志愿晚期结肠直肠癌患者 ,分为双路化疗组 (44例 )及单路静脉化疗组 (45例 )。双路化疗组给予吡喃阿霉素静推、羟基喜树碱静滴 ,5 Fu同顺铂腹腔灌注 ;静脉化疗组给予吡喃阿霉素静推、羟基喜树碱静滴、5 Fu静滴及顺铂静滴。两组以 2 1天为一疗程 ,治疗二疗程结束后评价疗效 ,随访三年以上。结果 :双路化疗组近期完全缓解 (CR)率 +部分缓解 (PR)率为 48 7%(19/ 39) ,二年生存率为 5 3 8%(2 1/39) ,毒副反应轻 ;静脉化疗组近期CR +PR率为 43 9%(18/ 41) ,二年生存率为 31 7%(13/ 41) ,毒副反应重。结论 :作者初步认为双路化疗法优于静脉化疗法。由于病例太少 ,最后结论有待于今后大宗病例的研究。

Objective: To evaluate the therapeutic effect and the toxicity results by using the chemotherapeutic method of intraperitoneal infusion combined with intravenous administration of chemotherapeutic agents(Bi-route method) for treating patients with advanced(stageⅢ b～Ⅳ) colorectal cancer.Methods:Form March 1996 till Aug 2002,89 cases of the volunteer patients with advanced colorectal cancer were divided into 2 groups randomly,Group A:44 patients were treated with 2 courses(1course=21 days) of 5-Fu(1000mg) and DDP(60mg) by intraperitoneal infusion,once per week,for 2 weeks,combined with THP(50mg～60mg)i.v.day 1,21;plus HCPT(12mg)i.v.instillation,day 1～5,(Bi-route Method Group);and group B,45 cases were treated with 5-Fu(750mg),day 1～5,DDP(40mg),day 1～3,HCPT(12mg) day 1～5,and THP(50mg-60mg)i.v.instillation,(Intravenous Instillation Alone Group).After completing the 2 couses of treatment,we compared the treatment effect and the toxicity of group A with those of group B. The follow-up period was 3 years for all 89 cases.Results:Among group A(Bi-route method group),39/44 cases wers eligible for evaluation.The CR+PR rate was 48.7%(19/39) at the time of completion of 2 courses treatment.The 2-year survival rate was 53.8%(21/39).The toxicity was mild.Among group B(i.v.Instillation Alone Group),41/45 cases were eligible for evaluation.The CR+PR rate was 43.9%,at the time of completion of 2 courses of treatment,and the 2-year -survival rate was 31.7%(13/41).The toxicity was severe.Conclusions:Our results showed that using Bi-route Method of chemotherapy may probably achieve better treatment with mild toxicity.The final conclusion should be made after further clinical trials of large number of patients with advanced colorectal cancer.