文献类型：期刊文献

中文题名：进展期结直肠癌动脉灌注新辅助化疗临床疗效观察

英文题名：Clinical effects of neoadjuvant chemotherapy via arterial infusion for advanced colorectal carcinoma

作者：弥海宁[1];何科基[2];杨言苹[3];李兴文[1];那光玮[2];赵晓宁[1]

第一作者：弥海宁

机构：[1]甘肃省肿瘤医院胃肠外科,兰州730050;[2]甘肃省肿瘤医院肝胆科,兰州730050;[3]甘肃中医学院附属医院麻醉科

第一机构：甘肃省肿瘤医院胃肠外科,兰州730050

年份：2011

卷号：27

期号：4

起止页码：417

中文期刊名：中国综合临床

外文期刊名：Clinical Medicine of China

收录：CSTPCD

语种：中文

中文关键词：结直肠癌;动脉灌注化疗;手术

外文关键词：Colorectal carcinoma;Chemotherapy via arteril infusion;Operation

摘要：目的 探讨术前动脉灌注化疗对进展期结直肠癌的远期临床疗效.方法 选择ⅡB、Ⅲ期的结直肠癌患者128例,随机分为2组：试验组68例行术前动脉灌注化疗,方案为：奥沙利铂（艾恒）130mg/m^2、羟基喜树碱20 mg/m^2、氟脲苷600 mg/m^2,经股动脉插管灌注化疗1、2次,8～14 d后接受手术治疗;对照组60例直接手术治疗.观察动脉灌注化疗不良反应及组织学疗效,比较2组手术切除率、手术并发症、术后病理分期及远期生存率.结果 试验组动脉灌注化疗不良反应主要表现为胃肠道反应和骨髓抑制,均属Ⅰ、Ⅱ度.试验组手术切除率为97.1%（66/68）、根治性切除率为96.9%,分别高于对照组的73.3%（44/60）和79.5%（Х^2=14.848、8.906,P均＜0.05）;试验组组织学有效率达72.7%,病理分期均较术前降低,其中Ⅱ期病例明显较对照组增多（P＜0.05）;试验组中位生存期为53.0个月,1、3、5年生存率分别为95.3%、85.9%、44.6%;对照组的中位生存期为42.0个月,1、3、5年生存率分别为92.6%、75.9%、22.0%,试验组生存率高于对照组,但只有5年生存率差异具有统计学意义（Х^2=6.385,P＜0.05）.术后并发症2组比较差异无统计学意义（P＞0.05）.结论 术前动脉灌注化疗对进展期结直肠癌降低临床分期、提高手术切除率尤其是根治性切除率作用和疗效确切,并能提高患者的远期生存率.
Objective To evaluate the curative effect of neoadjuvant chemotherapy via arterial infusion on advanced colorectal carcinoma. Methods One hundred and twenty-eight advanced colorectal carcinoma patients in stage Ⅱ B or Ⅲ were randomly divided into 2 groups. Sixty-eight cases received preoperative arterial infusion chemotherapy（ the treatment group）,and chemotherapy regimen consist of Oxaliplatin（L-OHP） 130 mg/m^2, Hydroxycamptothecin （HCPT） 20 mg/m^2 and Dexifluridine （FUDR）600 mg/m^2. Femoral arterial infusion chemotherapy administrated 8 ～ 14 days preoperative. Sixty cases received surgery directly（the control group）. The adverse reaction and histology effect after arterial infusion chemotherapy were observed, and resection rate,complications,pathology stage,together with long term survival were compared. Results Adverse reaction were mostly grade Ⅰ -Ⅱ gastrointestinal discomfort and bone marrow depression with arterial infusion chemotherapy. Resection rate was 97. 1% （66/68） ,and 64 cases（96. 9%） underwent raclical （R0） resection in the treatment group, which were higher than those in the the control group（73. 3%（44/60） and 79. 5%,respectively） （Х^2 = 14. 848,8. 906, Ps 〈 0. 05）. Histology effect of the treatment group was 72. 7%, and the pathology stage downstaged compared to preopeartion. Percent of patients in stage Ⅱ in the treatment group was higher than that in the control group（ P 〈 0. 05）. The median survival time of test group was 53. 0 months, 1- ,3-,and 5-year survival rates were 95.3%,85.9% and 44.6%, respectively. In the control group, the median survival time was 42.0 months, 1-, 3-, and 5-year survival rates were 92.6%, 75.9% and 22.0%,respectively. There was significant difference in 5-year survival rate（Х^2 = 6. 385, P 〈 0. 05）. No difference in postoperative complications between two groups（P 〉 0. 05）. Conclusion The neoadjuvant chemotherapy via arterial infusion is of great significance on downstnging the pathology of advanced colorectal carcinoma, raising the excision rate, especially radical resection, and long term survival rate.