术前动脉灌注化疗结合手术治疗直肠癌疗效分析

目的 :总结和分析直肠癌术前介入灌注化疗 (Pre operativeArteraInfusionChemotherapy ,PAIC)的疗效及其优点 ,探讨直肠癌综合治疗的远期疗效。方法 :应用Seldinger方法经皮右侧股动脉穿刺 ,选择肠系膜下动脉或骼内动脉造影确定肿瘤位置后 ,注入化疗药物。术后一周进行直肠癌根治术。术后采用 5 氟尿嘧啶加甲酰四氢叶酸钙进行 6个疗程的化疗。以同期未行介入灌注治疗而手术的直肠癌患者作为对照组。结果 :PAIC组大多数患者症状、体征减轻 ,肿块缩小。介入灌注化疗前后病理检查发现肿瘤细胞有变性坏死 ,细胞核变性 ,胞浆凝固 ,间质炎细胞浸润及纤维增生等不同程度的改变。术后五年生存率 75 0 0 % ,对照组为 4 5 2 4 % ,对比差异有显著性意义 (P <0 0 5 )。结论 :术前介入灌注化疗作为直肠癌新辅助化疗方法之一是有效、安全的 ,并能提高直肠癌患者的术后长期生存时间。

Analysing the Results in Combination of Pre-operative Arteria Infusion Chemotherapy and Operation for Rectal Cancer

Objective:To summarize and analyse th e curative effects and advantage of Pre-operative Arteria Infusion Chemotherapy ( PAIC) and go further into the long-term results of comprehensive treatment for r ectum cancer.Methods:Seldinger method was used to make sure of the place where the tumor lies by means of transcutanous intra-arterial (right femoral artery) intubation and the arterial radiography of intestinal membrance and ilium. Then the infusion of chemotherapeutic drugs was carried out. 7 days after PAIC,the patients received radical operation and 6 courses chemotherapy with FCF regimen. Concurrent patients receiving surgical treatment were chosen as the controls. Results:The clinical symptoms for most of the patients in PAIC group had been alleviated and the tumors had reduced in size. The pathologic examination showed that tumorous cells had changed greatly before and after PAIC. 5-year post-operative survival rate was 75.00% in the PAIC group and 45 .24% in the controls. The striking contrast of two groups differed greatly (P <0.05).Conclusion:PAIC is one of the effective,safe and auxiliary chemotherapeutic treatment for rectal cancer,and PAIC may improve the long t erm survival rate of the patients .