Pan Zhi-Zhong, Wan De-Sen, Lu Zhen-Hai, Li Li-Ren, Chen Gong, Zhou Zhi-Wei, Wu Xiao-Jun, Ding Pei-Rong, Wang Fu-Long
Department of Abdominal Surgery, Cancer Hospital, Sun Yat-sen University, Guangzhou 510060, China.
Zhonghua Wai Ke Za Zhi. 2004 Aug 7;42(15):918-21.
To compare the effect of 5-fluorouracil (5-FU) portal vein infusion (PVI) for 7 days after radical resection, with intraluminal chemotherapy during operation for eliminating liver metastasis and elevating long-term prognosis in colorectal cancer.
162 colorectal cancer patients with radical resection were divided into portal vein chemotherapy group (group A, 82 cases) and intraluminal chemotherapy group (group B, 80 cases) randomly. In group A, 5-fluorouracil were infused with 1g per day constantly for 7 days after operation through portal vein catheters, which placed into greater omental vein and fixed on the abdominal wall. In group B, intraluminal chemotherapy was given and 5-fluorouracil 0.5 g was injected into the greater omental vein during operation.
The short-term complications and long-term effect in the two groups were compared by statistical software SPSS 8.0. Group A had more operative complications, and no statistical differences was found in hospital time and survival rate of the two groups. The 5-year survival rate is 76.7% (group A: 74.3%, group B: 79.2%), and the liver metastasis rate is 19.8%. There is no significant difference between the two group-survival curves. Multiple variable analysis suggested that Dukes' stage was the prognosis factor (P < 0.05).
The present study demonstrated that the two chemotherapy methods play an important role in preventing liver metastasis and improving the survival rate, and the intraluminal chemotherapy would be easier and simpler. The result should be further improved by using combined chemotherapy.
比较结直肠癌根治术后门静脉输注5-氟尿嘧啶(5-FU)7天与术中肠腔内化疗在消除肝转移及提高长期预后方面的效果。
162例行根治性切除术的结直肠癌患者随机分为门静脉化疗组(A组,82例)和肠腔内化疗组(B组,80例)。A组术后通过置于大网膜静脉并固定于腹壁的门静脉导管每天持续输注1g 5-氟尿嘧啶,共7天。B组在术中向大网膜静脉注射0.5g 5-氟尿嘧啶进行肠腔内化疗。
采用统计软件SPSS 8.0对两组的短期并发症和长期效果进行比较。A组手术并发症较多,两组的住院时间和生存率无统计学差异。5年生存率为76.7%(A组:74.3%,B组:79.2%),肝转移率为19.8%。两组生存曲线无显著差异。多变量分析表明,Dukes分期是预后因素(P<0.05)。
本研究表明,两种化疗方法在预防肝转移和提高生存率方面均起重要作用,且肠腔内化疗更简便易行。联合化疗有望进一步改善结果。