结直肠癌根治术后门静脉化疗预防肝转移的研究

目的：探讨门静脉大剂量持续化疗对预防结直肠癌行根治术后并发肝转移的价值。方法：将病例分为研究组及对照组，研究组病人在行根治术后，选择大肠各汇流静脉（如在结肠静脉，肠系膜下静脉，乙状结肠静脉等）或胃网膜右静脉，将导管自所选择的静脉远侧端向门静脉方向插入至门静脉内，立即经此导管行5－Fu持续化疗，5－Fu用量为600mg/m^2.d^-1，化疗共持续7d，对照组则于术后2周开始全身化疗，5－Fu用量为450mg/m^2.d^-1，化疗共7d。结果：研究组病人5年生存率及5年内并发肝转移率分别为72．4％（55／76）及22．4％（17／76）；对照组病人5年生存率及5年内并发肝转移率分别为55．7％（39／70）及38．6％（27／70）。两组比较，有显著性差异（P＜0．05）。结论：结直肠癌根治术后即辅以门静脉大剂量持续化疗能明显降低肝转移，提高5年生存率。

A STUDY ON PORTAL CHEMOTHERAPY PREVENTING LIVER METASTASES AFTER OPERATION OF COLORECTAL CANCER

Objective:To investigate the Value of high dose of 5-fluorouracil (5-Fu) portal chemotherapy on preventing liver metastases after operation of colorectal cancer.Methods:Patientswere divided into study group and control group by using double-random method. After operation, 0.1 cm-diameter catheter was inserted from junction vena of colon(such as vena portae of right colon, colon sigmoideum or inferior mesenteric or gastroepip loicright vena portae) to vena portae, and 600 mg/m 2.d -1 of 5-Fu was constinuously infused for 7 days in the study group during these days, hemogram and variation of liver function were observed every two dsys. Meanwhile, after 2 weeks of operation, 450 mg/m 2.d -1 of 5-Fu was used for the controlled group patient in the same time.Result:Five-year survival rate and 5-year liver metastases rate were respectively 72.4%(55/76) and 22.4%(17/76) in study group. And 55.7%(39/70) and 38.6%(27/70) were in the control group. There was significant difference between these two groups (P< 0.05).Conclusion:lt can low liver metastases and improve 5-year survial rate for light dose of 5-Fu consistent portal chemothevapy after the operation of colorectal cancer.