腹腔热灌注化疗治疗晚期结直肠癌的疗效分析

doi:10.3969/j.issn.1005-6483.2020.05.009

摘要/Abstract

摘要： 目的:探究腹腔热灌注化疗（HIPEC）治疗晚期结直肠癌（CRC）并腹膜转移病人的临床疗效及预后。方法:2016年4月～2017年4月期间内我院收治的CRC伴腹膜转移病人71例。根据术后化疗方法不同将其分为观察组（34例）和对照组（37例）；其中，观察组术后采用HIPEC，对照组采用常规静脉化疗方案进行治疗。治疗满6个周期后，比较两组病人的临床疗效，血清肿瘤志物、生存质量、生存率及不良反应等情况。结果:观察组病人治疗总有效率和疾病控制率分别为67.6%和87.3%，对照组分别为40.5%和62.2%，两组比较差异有统计学意义（P<0.05）；治疗后观察组血清糖链抗原199（CA199）、CA125及癌胚抗原（CEA）分别为（24.21±1.98）、（37.97±2.93）和（16.26±2.02），对照组分别为（30.9±3.05）、（44.53±3.34）和（19.68±1.94），两组比较差异有统计学意义（P<0.05）。观察组治疗后KPS评分优于对照组，差异有统计学意义（P<0.05）；经治疗后两组相关并发症发生率无明显差异（P>0.05）。结论:HIPEC方案可提高CRC病人化疗的临床疗效，有效控制肿瘤进展并改善病人的免疫功能及生存质量。

关键词: 结直肠癌, 腹膜转移, 热灌注化疗, 免疫功能, 预后

Abstract: Objective:To explore the effect of intraperitoneal hyperthermic perfusion chemotherapy（HIPEC）on the clinical efficacy and prognosis of patients with peritoneal metastasis of advanced colorectal cancer（CRC）.Methods:A retrospective analysis of 71 patients with CRC peritoneal metastasis from 2016.4 to 2017.4.All the patients were randomly divided into the observation group（34 cases）and control group（37 cases）according to different postoperative treatment.Patients in observation group were treated with intraperitoneal hyperthermic perfusion chemotherapy，and patients in the control group were treated with conventional chemotherapy regimens.After 6 courses of treatment，clinical efficacy，related indicators of recurrence and metastasis，tumor markers，quality of life，and occurrence of adverse reactions after chemotherapy were compared between the two groups.Results:The total effective rate（67.6%）and disease control rate（87.3%）in the observation group were significantly higher than total effective rate（40.5%）and disease control rate（62.2%）in the control group（P<0.05）.After the treatment，the levels of serum carbohydrate antigen 199（CA199）（24.21±1.98），CA125（37.97±2.93），and carcinoembryonic antigen（CEA）（16.26±2.02）in the observation group were significantly lower than the levels of serum carbohydrate antigen 199（CA199）（30.9±3.05），CA125（44.53±3.34），and carcinoembryonic antigen（CEA）（19.68±1.94）in the control group（P< 0.05）.The KPS score was significantly improved，and the 3year survival rate were significantly better in the observation group than in the control group（P<0.05）.There was no significant difference in the incidence of complications between the two groups（P>0.05）.Conclusion:Intraperitoneal hyperthermic chemotherapy can significantly improve the clinical efficacy of chemotherapy in patients with CRC，and effectively control tumor progression and improve the immune function.It will provide novel methods and approaches for the effective treatment of advanced colorectal cancer.

Key words: colorectal cancer, 〓peritoneal metastasis, 〓hyperthermia chemotherapy, 〓immune function, 〓prognosis

狄子杨, 唐强, 狄茂军等. 腹腔热灌注化疗治疗晚期结直肠癌的疗效分析[J]. 临床外科杂志, 2020, 28(5): 433-436.

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