内镜下射频热疗联合局部化疗治疗晚期大肠癌的随机对照研究

目的：探讨射频加局部化疗治疗晚期大肠癌的疗效，并与单纯射频治疗比较。方法选择晚期大肠癌失去手术切除时机患者55例行射频加局部化疗或单纯射频治疗，随机分为射频加局部化疗组（A组）27例、射频组（B组）28例，观察两组患者5年内肠梗阻缓解率、再转移率、生存率。结果 A组与B两组1～5年肠梗阻缓解率分别为88.9%vs 70.8%、95.8 vs 70%、89.5%vs 52.9%、100%vs 33.3%、100%vs 0，具有统计学差异（P＜0.05）；5年内再转移情况，A组27例无一例出现再转移，再转移率为0（0/27），B组11例出现了新的转移病灶，再转移率为39.3%（11/28），有统计学差异（P＜0.05）；A组5年生存率为44.4%（19/27），B组为无一例生存，有统计学差异（P＜0.05）。结论内镜下射频热疗联合局部化疗能显著提高晚期大肠癌患者5年内肠梗阻缓解率和5年生存率，显著降低再转移率。

Clinical study on combined radiofrequency with local chemotherapy under endoscopy for treatment of advanced colorectal cancer

Objective To study the therapeutic effects of radiofrequency combined with local chemother-apy for treatment of the patients with advanced colorectal cancer. Methods Fifty five patients with advanced colorectal cancer without surgical treatment were randomly divided into two groups. Twenty seven cases in group A were treated with radiofrequency combined with local chemotherapy;while 28 cases in group B serve as control group with radiofrequency only. The bowel obstruction remission rates, re-metastasis and the sur-vival rates were analyzed. Results The remission rates of bowel obstruction in group A and group B since the first to the fifth year were respectively 88.9%vs 70.8%、95.8 vs 70%、89.5%vs 52.9%、100%vs 33.3%、100%vs 0 and statistical difference existed between the two groups （P〈0.05）. Re-metastasis took place in 11 （39.3%） cases in group B after five years, while no re-metastasis took place in group A （P〈0.05）. Five-year survival rate for the patients in group A was 44.4%（19/27）, while no patient in group B lived longer than 5 years （P〈0.05）. Conclusion The remission rate of bowel obstruction and the survival rate caused by ad-vanced colorectal cancer were significantly increased after radiofrequency combined with local chemotherapy treatment, and the re-metastasis rate was obviously decreased.