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目的观察微波消融术联合化疗夹心模式治疗直结肠癌术后肝转移癌的疗效。方法将直结肠癌术后肝转移癌无外科手术指征(或拒绝外科手术)的患者42例随机分为实验组和对照组。实验组:化疗+微波消融术+化疗(化疗方案:伊立替康+5-FU,次选择方案:奥沙利铂+5-FU,共完成8个周期);对照组:单纯化疗(化疗方案:伊立替康+5-FU,次选择方案:奥沙利铂+5-FU,共完成10个周期)。结果实验组和对照组治疗结束时完全缓解率分别为57.14%(12/21)和23.81%(5/21),部分缓解率分别为23.81%(5/21)和28.57%(6/21),稳定率分别为4.76%(1/21)和28.57%(6/21),有效率分别为80.95%(17/21)和52.38%(11/21),两组相比差异均有统计学意义(P<0.05),CEA、CA19-9转阴率实验组为71.43%(15/21),61.9%(13/21),对照组38.1%(8/21)、23.81%(5/21),两组相比差异均有统计学意义(P<0.05),实验组较对照组无进展生存时间平均延长5.9个月,3/4度骨髓抑制发生率实验组为19.04%(4/21),对照组治疗47.62%(10/21)。结论微波消融术联合化疗夹心模式治疗直结肠癌术后肝转移癌安全可靠、疗效确切,值得临床推广。
Objective To observe the curative effect of microwave ablation combined with chemotherapy sandwich model on postoperative liver metastases of patients with colon cancer. Methods Forty-two patients with postoperative liver metastases of colorectal cancer without surgical indications (or without surgery) were randomly divided into experimental group and control group. The experimental group: chemotherapy + microwave ablation + chemotherapy (chemotherapy: irinotecan + 5-FU, the second choice: oxaliplatin + 5-FU, a total of 8 cycles); control group: chemotherapy alone : Irinotecan + 5-FU, sub-option: oxaliplatin + 5-FU, a total of 10 cycles completed). Results The complete remission rate of the experimental group and the control group was 57.14% (12/21) and 23.81% (5/21) respectively, and the partial remission rates were 23.81% (5/21) and 28.57% (6/21) , The stability rates were 4.76% (1/21) and 28.57% (6/21) respectively, the effective rates were 80.95% (17/21) and 52.38% (11/21) (P <0.05). The negative rates of CEA and CA19-9 in the experimental group were 71.43% (15/21), 61.9% (13/21), 38.1% (8/21) and 23.81% (5/21) in the control group ), The differences between the two groups were statistically significant (P <0.05), the experimental group compared with the control group, the average progression-free survival time was 5.9 months, 3/4 degrees of myelosuppression in the experimental group was 19.04% (4/21 ) And 47.62% (10/21) in the control group. Conclusion Microwave ablation combined with chemotherapy sandwich model for the treatment of postoperative colorectal cancer liver metastases is safe and reliable, the curative effect is exact, worthy of clinical promotion.