术后预防性肝动脉灌注化疗对Ⅲ期结直肠癌长期生存的影响(1)
[摘要] 目的 探討预防性肝动脉灌注化疗(HAIC)对Ⅲ期结直肠癌术后长期生存的影响。 方法 回顾性分析2011年5月～2014年7月间在本院接受手术及术后辅助化疗的130例Ⅲ期结直肠癌患者。根据化疗方式，将患者分为两组：其中64例患者术后接受2个疗程HAIC及4个疗程全身化疗(HAIC组)；66例患者接受6个疗程全身化疗(对照组)。HAIC采用Seldinger法经股动脉穿刺置入导管，经动脉造影确认导管位于肝固有动脉或左右肝动脉后注入化疗药物。HAIC与全身化疗方案均包含：奥沙利铂(85 mg/m2)d1、5-Fu(2400 mg/m2) d2～3、四氢叶酸(200 mg/m2)d2～3。每4周1个疗程。观察比较两组长期生存。 结果 在术后3年内，HAIC组20例出现肝转移；对照组31例出现肝转移。HAIC组3年无肝转移生存率明显高于对照组(P=0.0379)。HAIC组31例术后出现复发，对照组41例出现复发。HAIC组较对照组具有更高的3年无瘤生存率(P=0.0427)。HAIC组24例死亡，对照组34例死亡。HAIC组3年总生存率明显高于对照组(P=0.0476)。 结论 预防性HAIC能显著降低Ⅲ期结直肠癌术后肝转移率及全身复发率，改善患者总生存率。
[关键词] 结直肠癌；肝动脉灌注化疗；肝转移；复发；长期生存
[中图分类号] R735.3 [文献标识码] B [文章编号] 1673-9701(2018)24-0075-04
Effect of postoperative prophylactic hepatic arterial infusion chemotherapy on long-term survival of stage Ⅲ colorectal cancer
ZHU Fangfang TANG Chengwu
Department of Surgery， First Hospital Affiliated to Huzhou Normal College， Huzhou 313000， China
[Abstract] Objective To explore the effect of prophylactic hepatic arterial infusion chemotherapy(HAIC) on the long-term survival of stage Ⅲ colorectal cancer patients. Methods 130 patients with stage Ⅲ colorectal cancer undergoing surgery and postoperative adjuvant chemotherapy from May 2011 to July 2014 in our hospital were retrospectively analyzed. According to the chemotherapy regimens， the patients were divided into two groups： 64 patients received 2 courses of postoperative HAIC and 4 courses of systemic chemotherapy(HAIC group)； 66 patients received 6 courses of systemic chemotherapy(control group). The HAIC group was placed with catheter through the femoral artery puncture by Seldinger method and was injected with chemotherapy drugs after the confirmation that the catheter was placed in the hepatic artery or left and right hepatic artery though arterial angiography. Both HAIC and systemic chemotherapy regimens included oxaliplatin(85 mg/m2)d1， 5-Fu(2400 mg/m2) d2-3， and tetrahydrofolate(200 mg/m2) d2-3， with every 4 weeks as a treatment course. The long-term survival of two groups was observed and compared. Results Within 3 years after surgery， 20 cases of hepatic metastasis occurred in the HAIC group and 31 cases of liver metastases occurred in the control group. The 3-year liver metastasis-free survival rate in the HAIC group was significantly higher than that in the control group(P=0.0379). There were 31 cases of postoperative recurrence in the HAIC group and 41 cases in the control group. The HAIC group had a higher 3-year disease-free survival rate than the control group(P=0.0427). There were 24 deaths in the HAIC group and 34 deaths in the control group. The 3-year overall survival rate in the HAIC group was significantly higher than that in the control group(P=0.0476). Conclusion Prophylactic HAIC can significantly reduce the liver metastasis rate and systemic recurrence rate in patients with stage Ⅲ colorectal cancer and improve the overall survival rate., http://www.100md.com(朱芳芳 唐成武)
[关键词] 结直肠癌；肝动脉灌注化疗；肝转移；复发；长期生存
[中图分类号] R735.3 [文献标识码] B [文章编号] 1673-9701(2018)24-0075-04
Effect of postoperative prophylactic hepatic arterial infusion chemotherapy on long-term survival of stage Ⅲ colorectal cancer
ZHU Fangfang TANG Chengwu
Department of Surgery， First Hospital Affiliated to Huzhou Normal College， Huzhou 313000， China
[Abstract] Objective To explore the effect of prophylactic hepatic arterial infusion chemotherapy(HAIC) on the long-term survival of stage Ⅲ colorectal cancer patients. Methods 130 patients with stage Ⅲ colorectal cancer undergoing surgery and postoperative adjuvant chemotherapy from May 2011 to July 2014 in our hospital were retrospectively analyzed. According to the chemotherapy regimens， the patients were divided into two groups： 64 patients received 2 courses of postoperative HAIC and 4 courses of systemic chemotherapy(HAIC group)； 66 patients received 6 courses of systemic chemotherapy(control group). The HAIC group was placed with catheter through the femoral artery puncture by Seldinger method and was injected with chemotherapy drugs after the confirmation that the catheter was placed in the hepatic artery or left and right hepatic artery though arterial angiography. Both HAIC and systemic chemotherapy regimens included oxaliplatin(85 mg/m2)d1， 5-Fu(2400 mg/m2) d2-3， and tetrahydrofolate(200 mg/m2) d2-3， with every 4 weeks as a treatment course. The long-term survival of two groups was observed and compared. Results Within 3 years after surgery， 20 cases of hepatic metastasis occurred in the HAIC group and 31 cases of liver metastases occurred in the control group. The 3-year liver metastasis-free survival rate in the HAIC group was significantly higher than that in the control group(P=0.0379). There were 31 cases of postoperative recurrence in the HAIC group and 41 cases in the control group. The HAIC group had a higher 3-year disease-free survival rate than the control group(P=0.0427). There were 24 deaths in the HAIC group and 34 deaths in the control group. The 3-year overall survival rate in the HAIC group was significantly higher than that in the control group(P=0.0476). Conclusion Prophylactic HAIC can significantly reduce the liver metastasis rate and systemic recurrence rate in patients with stage Ⅲ colorectal cancer and improve the overall survival rate., http://www.100md.com(朱芳芳 唐成武)