区域动脉灌注化疗在结直肠癌术前应用的远期疗效观察

目的 探讨结直肠癌术前区域动脉灌注化疗（PRAC）对远期生存的影响和副作用。方法 采用Seldinger技术对52例结直肠癌患者术前行PRAC，在供血动脉注入氟脱氧尿苷（FuDR）和奥沙利铂（L-OHP）等化疗药物，7d后行结直肠癌根治术，术后予以化疗。对照组56例则均为同期未行PRAC而直接行结直肠癌根治术的患者，术后接受同样方案化疗，以术后1、3年累积生存率、无病生存率和术后副反应为主要观察目标。结果 PRAC组患者的1年累积生存率为83.8%，对照组为78.6%；3年累积生存率为71.6%，对照组为59.6%。2组间的生存率差异有统计学意义(P<0.05)。PRAC组患者的1年无病生存率为71.2%，对照组为65.8%；3年无病生存率为50.4%，对照组为33.8%，差异有统计学意义。PRAC组和对照组术后副作用发生率差异无统计学意义(P>0.05)。结论 PRAC能有效改善结直肠癌患者的远期生存，方法简便安全，副作用少，值得在临床推广应用。

The long-term clinical effects of preoperative regional arterial infusion chemotherapy against colorectal cancer

【Abstract】Objectives To investigate the clinical effects of preoperative regional arterial infusion chemotherapy (PRAC) to long-term results and the side effects of colorectal cancer after radical operation. Methods In the PRAC group, Seldinger techniques was used to insert tube into the nutrient artery of 52 colorectal cancer , FuDR and L-OHP were infused into the nutrient artery. Radical operation was done after 7 days and general venous chemotherapy was administered every 2 weeks after operation.The control group underwent radical surgery directly and the same general venous chemotherapy was given to the 56 patients by the same interval. The main observation points were cumulative survival rate, disease free survival and the side effects. Results In the PRAC group,1-,3- cumulative survival rate were 83.8%,71.6% respectively, all significantly better than those in the control group(78.6%, 59.6% respectively, P<0.05). The 1-,3- disease free survival rate of PRAC group were 71.2% and 50.4% respectively，all significantly better than those in the control group(65.8%, 33.8% respectively, P<0.05).There was no significant difference in post-operation side-effects and complications between the two groups. Conclusion PRAC can effectively improve the long-term survival of colorectal cancer. It has little side-effects and deserved to be applied in the long run.