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目的观察结直肠癌术后腹腔热灌注联合全身化疗的疗效及不良反应。方法将我科2000-03—2003-01收治的50例T4病变结直肠癌术后患者采用信封法随机分为腹腔热灌注联合全身化疗的治疗组26例和单纯行全身化疗的对照组24例,观察两组患者腹腔复发率、肝转移率及1年、3年、5年生存率。结果治疗组腹腔复发率及肝转移率明显低于对照组(23.1%vs50.0%,15.4%vs41.7%,P<0.05),治疗组1年、3年及5年的生存率明显高于对照组(92.3%vs91.7%,69.2%vs50.0%,38.5%vs20.8%,P<0.05)。两组严重不良反应比较差异无统计学意义(P>0.05)。结论本研究提示T4病变结直肠癌术后腹腔热灌注联合全身化疗,能有效降低术后腹腔复发及肝转移,而且提高患者的生存率,不良反应能够耐受。
Objective To observe the efficacy and adverse reactions of postoperative intraperitoneal hyperthermic perfusion combined with systemic chemotherapy in patients with colorectal cancer. Methods Fifty patients with T4 lesions in colorectal cancer who were treated in our department from March 2000 to March 2003 were enrolled in the study. Twenty-six patients in the treatment group treated with intraperitoneal hyperthermic perfusion combined with systemic chemotherapy and 24 patients in the control group treated with systemic chemotherapy alone The abdominal recurrence rate, hepatic metastasis rate and 1-year, 3-year and 5-year survival rates of the two groups were observed. Results The intraperitoneal recurrence rate and hepatic metastasis rate in the treatment group were significantly lower than those in the control group (23.1% vs 50.0%, 15.4% vs 41.7%, P <0.05). The survival rates at 1, 3 and 5 years in the treatment group were significantly higher In the control group (92.3% vs91.7%, 69.2% vs50.0%, 38.5% vs20.8%, P <0.05). There was no significant difference in serious adverse reactions between the two groups (P> 0.05). Conclusion This study suggests that postoperative intraperitoneal hyperthermic perfusion combined with systemic chemotherapy after T4 lesion colorectal cancer can effectively reduce postoperative abdominal recurrence and liver metastasis, and improve patient survival rate, adverse reactions can tolerate.