进展期直肠癌术中植入氟尿嘧啶缓释剂的疗效观察

目的 探讨进展期直肠癌术中腹腔内植入氟尿嘧啶缓释剂的疗效.方法 104例进展期直肠癌,在直肠癌根治术中即时低渗温热腹腔化疗联合腹腔内植入氟尿嘧啶缓释剂37例(氟尿嘧啶组),术中即时低渗温热腹腔化疗联合术后早期腹腔化疗弘例(联合化疗组),只行蒸馏水腹腔灌洗33例(对照组).结果 氟尿嘧啶组消化道反应的发生率(2.70%,1/37)低于联合化疗组(20.59%,7/34,x2=9.104,P＜0.05),3组患者1年生存率差异无统计学意义(P＞0.05),氟尿嘧啶组的2年生存率(78.37%,29/37)明显高于高于对照组(48.48%,16/33,x2=1.297,P＜0.05),随访2年局部复发率明显低于对照组21.62%(8/37)与32.35%(11/34),x2=7.001,P＜0.05],但与联合化疗组(32.35%,11/34)比较差异无统计学意义(P＞0.05).结论 进展期直肠癌术中腹腔内植入氟尿嘧啶缓释剂是一种有效且毒副反应轻的腹腔化疗方法.

Abstract：

Objective To assess the effect of intraperitoneal interstitial implant of Sustained-release 5-Fluorouracil during operation for advanced rectal cancer. Methods One hundred and four cases with advanced rectal cancer were enrolled into the study and divided into 3 groups: treatment group 1(n = 37), underwent combined hypotonic peritoneal chemo-hyperthermia and Sustain-released 5-fluorouracil implantation treatment during operation; treatment group 2(n = 34), underwent combined intraoperative hypotonic peritoneal chemohyperthermia and early postoperatively intraperitoneal chemotherapy treatment; and control group(n = 33),underwent peritoneal lavage during radical resection alone. Results Digestive tract toxicity in group 1 was significantly lower than that in group 2(2. 70% vs. 20. 59%, x2 = 9. 104, P ＜ 0. 05). There were significant difference on 1 year survival rate among the three groups. The 2-year survival rate of group 1 was significantly higher than that in the control group (78. 37% vs. 48. 48%, x2 = 1. 297 ,P ＜ 0. 05). After two years follow-up the 2-year local recurrence rate of group 1 was significantly lower than that in the control group(21.62% vs 32. 35 %, x2 = 7. 001, P ＜ 0. 05). However, no significant difference was found compared to group 2, which was 32. 35%. Conclusion lntraperitoneal interstitial implant of Sustain-released 5-Fluorouracil during operation is an effective intraperitoneal chemotherapy with mild side effects for advanced rectal cancer.

Effect of implanted sustain-released 5-fluorouracil during operation in patients with advanced rectal cancer

Objective To assess the effect of intraperitoneal interstitial implant of Sustained-release 5-Fluorouracil during operation for advanced rectal cancer. Methods One hundred and four cases with advanced rectal cancer were enrolled into the study and divided into 3 groups: treatment group 1(n = 37), underwent combined hypotonic peritoneal chemo-hyperthermia and Sustain-released 5-fluorouracil implantation treatment during operation; treatment group 2(n = 34), underwent combined intraoperative hypotonic peritoneal chemohyperthermia and early postoperatively intraperitoneal chemotherapy treatment; and control group(n = 33),underwent peritoneal lavage during radical resection alone. Results Digestive tract toxicity in group 1 was significantly lower than that in group 2(2. 70% vs. 20. 59%, x2 = 9. 104, P ＜ 0. 05). There were significant difference on 1 year survival rate among the three groups. The 2-year survival rate of group 1 was significantly higher than that in the control group (78. 37% vs. 48. 48%, x2 = 1. 297 ,P ＜ 0. 05). After two years follow-up the 2-year local recurrence rate of group 1 was significantly lower than that in the control group(21.62% vs 32. 35 %, x2 = 7. 001, P ＜ 0. 05). However, no significant difference was found compared to group 2, which was 32. 35%. Conclusion lntraperitoneal interstitial implant of Sustain-released 5-Fluorouracil during operation is an effective intraperitoneal chemotherapy with mild side effects for advanced rectal cancer.