奥沙利铂联合方案区域动脉灌注治疗晚期大肠癌的临床观察

Clinical trial of transcathater arterial infusion (TAI) chemotherapy with oxaliplatin plus 5-Fu/CF in treatment of advanced colorectal cancer

目的 观察奥沙利铂 (L -OHP)联合甲酰四氢叶酸 (CF)和 5 -氟尿嘧啶 (5 -Fu)腹腔区域动脉灌注治疗晚期大肠癌的临床效果和毒副反应。方法 采用Seldinger方法 ,2 3例晚期大肠癌患者根据肿瘤部位不同将导管插入相应主要供血动脉 ,治疗组 1 1例 ,动脉灌注L -OHP、CF、5 -Fu ;对照组 1 2例 ,动脉灌注顺铂 (PDD)、CF、5 -Fu。每三周重复一次 ,治疗二次后评价疗效。结果 临床症状缓解率、肿瘤有效率 :治疗组为 72 .7%、6 3.6 % ;对照组为 4 1 .7%、33.3% ;两组有显著性差异(P <0 .0 5 )。两组毒副反应主要有恶心、呕吐、腹泻、粘液血便、白细胞下降 ,大多为Ⅰ～Ⅱ度 ;对照组发生率较治疗组高 ,治疗组感觉神经毒性明显升高 ,但停药后可缓解。结论 L -OHP联合CF、5 -Fu腹腔区域动脉灌注治疗晚期大肠癌具有疗效好 ,毒副反应轻。

Objective To evaluate the clinical efficacy and toxicity of TAI chemotherapy with Oxaliplatin (L-OHP) plus 5-Fu/CF in treatment of advanced colorectal cancer. Methods 23 colorectal cancer patients received TAI with seldinger technique, and the pipe was inserted into the arteries that supply tumor with nutrition. The treatment group: 11 colorectal cancer patients was treated using L-OHP plus 5-Fu/CF through the pipe; The control group: Other 12 patients are treated using PDD plus 5-Fu/CF through the same pipe. The above regimen was repeated every three weeks. The curative effect was evaluated two weeks later.Results The clinical symptom and the overall response rate of the treatment group were 72.7 % and 63.6 % respectinely; while 41.7 % and 33.3 % in control group with significant difference (P< 0.05 ). The major toxicities included nausea and vomiting, diarrhea, muciform hematochezia, leukopenia; The toxicities of the control group were more severe than those of the treatment group. Neurosensory toxicity was higher in treatment group patients.Conclusions TAI chemoherapy with L-OHP puls 5-Fu/CF is safe and effective in treatmeat of advanced colorectal cancer.