结肠癌术中区域化疗与肠腔化疗5-Fu浓度比较

目的:比较结肠癌术中区域化疗(regional chemotherapy,RC)与肠腔化疗门静脉、周围静脉、腹腔液和癌旁组织5-Fu的浓度。方法:结肠癌术中,RC组经区域动脉灌注含5-Fu(15.0 mg/kg)的化疗液100.0 mL,肠腔化疗组经肠腔灌注含5-Fu(15.0 mg/kg)的化疗液100.0 mL,于注药后2、5、10、20、30、60 min分别采集门静脉血液、周围静脉血液、腹腔液和癌旁组织,高效液相色谱法测定样本5-Fu浓度。结果:RC组各样本注药后2 min即出现峰浓度,并逐渐降低,其中腹腔液血药浓度最高,周围静脉血血药浓度低于门静脉血。肠腔化疗组,门静脉血液、腹腔液和癌旁组织在注药后2 min即测得5-Fu,但浓度显著低于RC组(P<0.01),此后,门静脉血5-Fu浓度上升,并于60 min高于RC组(P<0.01);周围静脉血未测得5-Fu。结论:结肠癌术中RC可使门静脉血液和腹腔液维持比较高的血药浓度,对术中转移和术后复发具有治疗和预防作用。

Comparison of 5-Fu concentrations between intra-operational regional chemotherapy and intraluminal chemotherapy for colon cancer

Objective:To detect 5-Fu concentration in serum,peritoneal fluid and pericancerous tissues between intra-operational regional chemotherapy(RC) and intraluminal chemotherapy for colon cancer.Methods: Twenty colon cancer patients received intra-operational RC with 5-Fu(15 mg/kg).Another twenty colon cancer patients received intraluminal chemotherapy with 5-Fu(15 mg/kg).On 2,5,10,20,30 and 60 minutes after administration,portal vein blood,peripheral circulation blood,peritoneal fluid and pericancerous tissue were sampled to analyze the 5-Fu concentration by high performance liquid chromatography(HPLC) method.Results: Peak concentration appeared two minutes after treatment,and lowered gradually in the RC group.The drug level in peritoneal fluid was the highest,and that in the peripheral vein was lower than that in portal vein.5-Fu was detected in the portal vein blood,peritoneal fluid,and pericancer tissues in the intraluminal,chemotherapy group at two minutes,and were significantly lower than that of the RC group(P<0.01).The concentration in portal vein upgrade slowly reaching its maximum concentration at 60 minutes and exceed that of the RC group(P<0.01).5-Fu was not detected in the peripheral circulation blood.Conclusion:The intra-operational RC for colon cancer maintains a higher concentration of chemotherapy in portal vein blood and peritoneal fluid.This has significance in prophylaxis for cancer intra-operational spreading and forestalls the recurrence post-operation.