大肠癌根治术后门静脉置管5-FU化疗的临床研究

目的:探讨大肠癌根治术后门静脉置管 5 -氟脲嘧啶 (5 - FU)化疗的临床疗效。方法 :对 30例 Dukes A、B、C期大肠癌患者进行 1∶ 2匹配的病例对照研究 ,根治性切除加门静脉化疗 10例作为治疗组 ,单纯根治术 2 0例作为对照组 ,治疗组于根治术当日即以 5 - FU1.0 g持续 2 4 h门静脉滴注化疗 7d,对照组住院期间不作辅助化疗。2组均术后定期外周静脉化疗 ,每年进行随访。 结果:(1)治疗组、对照组住院期间发生并发症分别为 3例 (30 % )、4例 (2 0 % ) ,2组并发症发生率差异无统计学意义 (P >0 .0 5 ) ;(2 )治疗组、对照组术后 1、2、3、5年肝转移率分别为 2 0 %、30 %、30 %、30 %和 5 %、10 %、2 0 %、2 5 % ,2组差异无统计学意义 (P >0 .0 5 ) ;(3)治疗组、对照组术后 1、3、5年生存率分别为 80 %、6 0 %、6 0 %和 95 %、6 5 %、4 0 % ,2组间差异均无统计学意义 (P>0 .0 5 )。 结论 :大肠癌根治术后门静脉插管化疗并不能有效降低肝转移率和提高生存率 ,说明了该疗法的全身化疗作用而非局部作用。

The clinical study of chemotherapy by portal vein infusion for colorectal cancer after radical resection

Objective: To prevent hepatic metastasis from colorectal cancer and improve survival rate of patients. Methods: Among the 30 patients after a radical resection with 10 patients received 5-FU-based chemotherapy by portal vein infusion (PVI),The others had no further treatment. The therapy group received 5-FU (1.0 g/d,continued 7 d) chemotherapy by PVI on the operation day. The control group did not receive this chemotherapy. Patients of both groups recieved chemotherapy via peripheral vein after radical resection on time and were followed every year. Results: The hepatic metastasis rate was statistically no significance between both groups,and the survival rate of 1,3,5 years was statistically no significance too. Conclusions: PVI after surgery in some of the patients with colorectal cancer can not reduce the rate of liver metastases and improve the survival rate. The result suggested the systemic effect of chemotherapy via peripheral vein instead of the effect of chemotherapy of local organ.