5-Fu/LV+L-OHP方案静脉及腹腔热灌注化疗对T4期结直肠癌的疗效对比观察

目的观察比较草酸铂腹腔热灌注与单纯静脉化疗治疗T4期结直肠癌的疗效和毒副作用。方法将病理检查确诊的60例T4期结直肠癌患者随机分成2个组，2组均先给予亚叶酸钙和氟脲嘧啶静脉输注。比较草酸铂腹腔热灌注化疗配合局部射频透热治疗和单纯静脉输注的疗效。结果静脉化疗＋腹腔热灌注组有效率为59．3％，中位生存期11．0个月，中位无进展生存期9．2个月。单纯静脉化疗组有效率为35．7％，中位生存期9．7个月，中位无进展生存期7．0个月。静脉化疗十腹腔热灌注组中位生存期（11．0个月）长于单纯静脉化疗组（9．7个月），有统计学差异（P〈0．05）。静脉化疗＋腹腔热灌注组腹水治疗有效率86．7％，单纯静脉化疗组有效率50．0％，2个组有显著差异（P〈0．05）。静脉化疗＋腹腔热灌注组毒副反应主要为腹部不适。结论草酸铂腹腔热灌注化疗疗效有所提高，毒性尚可耐受，值得进一步研究。

Clinical Study of Intraperitoneal Chemohyperthermia(IPCH) with Oxaliplatin for Patients with Peritoneal Carcinomatosis of Colorectal Cancer

Objective To determine the therapeutic efficacy and side effect of intraperitoneal chemohyperthermia(IPCH) with oxaliplatin(LOHP) compared with intravenous(i.v.) chemotherapy for patients with peritoneal carcinomatosis of colorectal cancer.Methods 60 patients with pathologically documented peritoneal carcinomatosis of colorectal cancer,were randomly divided into 2 groups.The two groups both received an intravenous perfusion of 5-fluorouracil and leucovorin,followed either by IPCH with oxaliplatin,combined with local radiofrequency hyperthermic chemotherapy,or by intravenous perfusion of oxaliplatin.Then the curative effect of the two method was compared.Results The response rate was 59.3% in group IPCH with a median progression-free survival time of 9.2 months and a median survival time of 11.1 months.In group with i.v.chemotherapy,the response rate was 35.7% with a median progression-free survival time of 7.0 months and a median survival time of 9.7 months.The survival time was longer in group IPCH than in group with i.v.chemotherapy(P<0.05).The overall response rate of ascites treatment was 86.7%,which was significantly different between the two groups(P<0.05).Major toxicities of IPCH included mild cumulative neuropathy and abdominal discomfort.Conclusion The intraperitoneal chemohyperthermia(IPCH) with oxaliplatin(LOHP) can increase the chemotherapy effect for patients with peritoneal carcinomatosis of colorectal cancer with tolerable side effects.Further research is needed to determine its clinical value.