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目的探讨选择性髂内动脉区域靶向灌注化疗对直肠癌患者术后预后的影响。方法选取2010年2月至2013年2月沈阳市苏家屯区中心医院收治的116例直肠癌患者作为研究对象,将其采用随机数字表法分为观察组与对照组,各58例。两组患者均实施直肠癌根治术,同时对照组患者术后辅以全身静脉化疗,观察组患者术中行单侧或双侧髂内动脉化疗泵植入术,术后行区域靶向灌注化疗联合全身化疗。比较两组患者并发症发生情况、局部复发和远处转移情况及治疗后第1年、第2年、第3年生存情况。结果观察组患者的并发症发生率显著低于对照组,差异有统计学意义(P<0.05);观察组患者随访3年内局部复发率和远处转移率均明显低于对照组,差异均有统计学意义(均P<0.05);观察组患者治疗后第2、3年的生存率均明显高于对照组,差异均有统计学意义(均P<0.05);观察组患者术后生存时间为(33±4)个月,明显长于对照组的(27±4)个月,差异有统计学意义(t=12.651,P<0.05)。结论直肠癌患者采用选择性髂内动脉区域靶向灌注化疗,能改善预后,提升患者治疗后3年内生存率,且局部复发率、并发症发生率、远处转移率均较低,安全可靠。
Objective To investigate the effect of selective perfusion chemotherapy of selective internal iliac artery on postoperative prognosis of patients with rectal cancer. Methods One hundred and sixty-six patients with rectal cancer admitted to Central Hospital of Sujiatun District, Shenyang from February 2010 to February 2013 were enrolled in this study. The patients were randomly divided into observation group and control group, with 58 cases in each group. In both groups, radical resection of rectal cancer was performed, while patients in the control group received postoperative systemic intravenous chemotherapy. Patients in the observation group underwent unilateral or bilateral internal iliac artery chemotherapy pump implantation and regional targeted infusion chemotherapy Systemic chemotherapy. The complication, local recurrence and distant metastasis of the two groups were compared, and the first, second and third year after treatment were compared. Results The incidence of complications in the observation group was significantly lower than that in the control group (P <0.05). The local recurrence rate and distant metastasis rate in the observation group within 3 years of follow-up were significantly lower than those in the control group (All P <0.05). The survival rates in the second and third year after treatment in the observation group were significantly higher than those in the control group (all P <0.05). The survival time (33 ± 4) months, which was significantly longer than that of the control group (27 ± 4) months, the difference was statistically significant (t = 12.651, P <0.05). Conclusion Rectal cancer patients with selective internal iliac artery targeting perfusion chemotherapy can improve the prognosis and improve the survival rate of patients within 3 years after treatment, and the local recurrence rate, complication rate, distant metastasis rate is low, safe and reliable.