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目的 :探讨肿瘤深部热化疗对复发转移性结直肠癌患者生存的影响及预后相关因素。方法:108例复发转移性结直肠癌患者中,53例接受热化疗[肿瘤深部热疗联合XELOX方案(卡培他滨联合奥沙利铂)全身化疗],55例仅接受XELOX方案全身化疗。比较2组的总生存,评价治疗前血清白蛋白(albumin,ALB)水平、血清前白蛋白(prealbumin,PA)水平和外周血中性粒细胞/淋巴细胞比值(neutrophil/lymphocyte ratio,NLR)与肿瘤深部热化疗患者预后的关系。结果:热化疗组患者的中位生存时间显著优于化疗组(23 vs 18个月,P=0.032)。热化疗患者中,血清ALB≥35 g/L、血清PA≥200 g/L、外周血NLR<3.3的患者的总生存显著优于血清ALB<35 g/L(中位生存时间分别为35和11个月,P=0.001)、血清PA<200 g/L(中位生存时间分别为39和13个月,P=0.001)、外周血NLR≥3.3(中位生存时间分别为35和13个月,P=0.040)的患者。结论:深部热化疗治疗复发转移性结直肠癌患者可改善患者的总生存。血清ALB和PA水平以及外周血NLR可能预测肿瘤深部热化疗患者的预后。
Objective: To investigate the effect of deep tumor thermochemotherapy on the survival of patients with recurrent metastatic colorectal cancer and its prognostic factors. METHODS: Of the 108 patients with recurrent metastatic colorectal cancer, 53 received thermochemotherapy [systemic deep hyperthermia combined with XELOX regimen (capecitabine plus oxaliplatin)] and 55 received systemic chemotherapy with XELOX regimen alone. The levels of albumin (ALB), prealbumin (PA) and neutrophil / lymphocyte ratio (NLR) were compared between the two groups before and after treatment Prognosis of patients with deep tumor thermochemotherapy. Results: The median survival time in the thermochemotherapy group was significantly better than that in the chemotherapy group (23 vs. 18 months, P = 0.032). In patients with hyperthermia, the overall survival of patients with serum ALB≥35 g / L, serum PA≥200 g / L and peripheral blood NLR <3.3 was significantly better than that of serum ALB <35 g / L (median survival 35 and 11 months, P = 0.001), serum PA <200 g / L (median survival 39 and 13 months respectively, P = 0.001) and peripheral blood NLR ≥3.3 (median survival 35 and 13, respectively Month, P = 0.040). Conclusion: Deep thermochemotherapy in patients with recurrent metastatic colorectal cancer can improve the overall survival of patients. Serum ALB and PA levels and peripheral blood NLR may predict the prognosis of patients with deep tumor thermochemotherapy.