Lin Chang-Ping, Chi Pan
Department of General Surgery, Union Hospital, Fujian Medical University, Fuzhou 350001, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2009 May;12(3):257-60.
To compare the clinical efficacy of postoperative intraperitoneal chemotherapy combined with systemic chemotherapy to systemic chemotherapy alone for serosa-involved colorectal cancer.
According to the criteria of serosa-involving in colorectal cancer, 332 cases were divided into 2 groups prospectively without randomization. Study group(n=166) was treated with intraperitoneal chemotherapy combined with systemic chemotherapy, and control group(n=166) with systemic chemotherapy alone. Incidence of local recurrence, peritoneal metastasis, hepatic metastasis, other distant metastasis and 3-year, 5-year overall survival(OS) rate of two groups were compared.
3-year and 5-year OS rates of stage II(B in study group were similar to those in control group(chi(2)=0.612,P=0.434). The above rates of stage III( in study group were higher than those in control group(chi(2)=3.989,P=0.046). Either the study group or the control group, the 3-year and 5-year OS rates of patients undergone laparoscopic surgery or open surgery were similar(P=0.839, P=0.172). Incidences of local recurrence, peritoneal metastasis and hepatic metastasis in study group were 1.9%,3.8% and 3.8% respectively, lower than those in control group(8.2%,9.5% and 10.1%,P<0.05). Distant metastasis rate in study group was similar to that in control group. In study group, intraperitoneal chemotherapy regimen with Oxaliplatin had lower rates of peritoneal metastasis and hepatic metastasis as compared to that with Cisplatin(0.9% vs 8.8%,P=0.019), while the incidences of local recurrence and other distant metastasis were similar.
Postoperative intraperitoneal chemotherapy combined with systemic chemotherapy improves 3-year and 5-year overall survival rates in patients with stage III( serosa-involved colorectal cancer, and decreases local recurrence, peritoneal metastasis and liver metastasis rate, especially when intraperitoneal chemotherapy regimen contains Oxaliplatin. Comparing with open surgery, laparoscopic surgery dose not improve 3-year and 5-year overall survival rates in patients receiving combined chemotherapy or systemic chemotherapy alone.
比较术后腹腔内化疗联合全身化疗与单纯全身化疗治疗浆膜受累结直肠癌的临床疗效。
根据结直肠癌浆膜受累标准，前瞻性地将332例患者非随机分为2组。研究组（n = 166）接受腹腔内化疗联合全身化疗，对照组（n = 166）仅接受全身化疗。比较两组局部复发、腹膜转移、肝转移、其他远处转移的发生率以及3年、5年总生存率（OS）。
II期（B）研究组的3年和5年OS率与对照组相似（χ² = 0.612，P = 0.434）。III期（研究组的上述率高于对照组（χ² = 3.989，P = 0.046）。在研究组或对照组中，接受腹腔镜手术或开放手术患者的3年和5年OS率相似（P = 0.839，P = 0.172）。研究组局部复发、腹膜转移和肝转移的发生率分别为1.9%、3.8%和3.8%，低于对照组（8.2%、9.5%和10.1%，P < 0.05）。研究组远处转移率与对照组相似。在研究组中，与顺铂腹腔内化疗方案相比，奥沙利铂腹腔内化疗方案的腹膜转移和肝转移率较低（0.9%对8.8%，P = 0.019），而局部复发和其他远处转移的发生率相似。
术后腹腔内化疗联合全身化疗可提高III期（浆膜受累结直肠癌患者的3年和5年总生存率，并降低局部复发率、腹膜转移率和肝转移率，尤其是当腹腔内化疗方案包含奥沙利铂时。与开放手术相比，腹腔镜手术不能提高接受联合化疗或单纯全身化疗患者的3年和5年总生存率。
Zotero 插件