进展期结直肠癌术后联合化疗的临床观察

目的：探讨进展期结直肠癌术后静脉联合腹腔化疗的临床疗效。方法：进展期结直肠癌根治术后102例随机分成联合化疗组（观察组）与静脉化疗组（对照组）各51例，观察两组病人化疗后不良反应、术后复发和转移情况及5年内生存率，并进行分析比较。结果：观察组的胃肠道反应、骨髓抑制和急性肾功能损害的发生率明显低于对照组，腹腔和肝转移率及局部复发率低于对照组（P〈0．05），而观察组的其他远处转移率与对照组无明显差异（P〉0．05），观察组2、3、4和5年的生存率分别为98．0％、88．2％、74．4％和62．0％，明显高于对照组（86．3％、70．4％、51．8％和31．9％。结论：术后行联合化疗，降低了化疗的毒副反应，降低了术后的复发率和转移率，延长生存期，是进展期结直肠癌术后理想的化疗方式。

Clinical observation of postoperative combined chemotherapy in advanced colorectal carcinoma

Objective:To elevate the effects of postoperative combined chemotherapy in advanced colorectal carcinoma.Methods:From Oct.1996 to Oct.1999,102 patients after radical surgery with advanced colorectal carcinoma were divided into 2 groups at random.One group was treated with intravenous chemotherapy,another with combined chemotherapy.The side effects to therapeutic regimens,occurrence of local metastases,peritoneal metastases,hepatic metastases and other distant metastases was observed.The 2 ,3 ,4 and 5 year survival rates were analyzed.Results:The side effects rates to therapeutic regimens were much lower than that of the intravenous chemotherapy group.Peritoneal and hepatic metastases combined chemotherapy group(15.7%,19.6%)were much lower than that of the intravenous chemotherapy group(35.3%,37.3%)(P<0.05).The distant metastases rate except hepatic metastases of the combined chemotherapy group(15.7%)was similar to that of the intravenous chemotherapy group(11.8%).The 2 ,3 ,4 and 5 year survival rate of the combined chemotherapy group(98.0%,88.2%,74.4%,62.0%)were much higher than those of the intravenous chemotherapy group(86.3%,70.4%,51.8%,31.9%).Conclusion:Patients with advanced colorectal carcinoma were adaptable to combined chemotherapy after radical operation.It had caused less side effects,a lower peritoneal metastasis rate,a lower hepatic metastases rate,and a higher 5 year survival rate.