Wan D S
Tumor Hospital, Zhongshan University of Medical Sciences, Guangzhou.
Zhonghua Zhong Liu Za Zhi. 1988 Sep;10(5):388-91.
Eighty-two patients with colo-rectal cancers (29 colon and 53 rectum) were admitted and underwent radical resection from January 1982 to June 1984. There were 54 males and 28 females. The ages ranged from 25 to 74 years. According to Dukes's classification, there were 2 Stage A, 47 (57.3%) Stage B and 33 (40.2%) Stage C. Histologically, 70.7% were adenocarcinoma, 20.7% mucinous carcinoma and 8.6% others. All these patients were randomized into two groups: trial group and control group. In the trial group, there were 45 patients treated by radical resection plus adjuvant intraluminal 5-FU chemotherapy and intravenous 5-FU chemotherapy on the first and second days postoperatively. The intraluminal dose of 5-FU was 30 mg/kg injected into the bowel lumen of the isolated diseased segment between the tape ligatures. The intravenous dose was 10 mg/kg given on the first and second days after operation. In the control group, there were 37 patients treated by radical resection alone. The survival rates were calculated by the life-table method and the results showed that in patients with Dukes' C, the 5-year survival rate of the trial group was 61.8%, and that of the control group was 27.3% (P less than 0.05). In addition, hepatic metastasis in the trial group was less than that in the control group. The results of the randomized trial indicated that adjuvant intraluminal 5-FU chemotherapy may be an important approach to improve the results of radical resection for advanced colo-rectal cancer and to prevent hepatic metastases. Further clinical studies are recommended.
1982年1月至1984年6月,收治了82例结直肠癌患者(29例结肠癌,53例直肠癌)并接受根治性切除。其中男性54例,女性28例。年龄范围为25至74岁。根据Dukes分期,有2例A期,47例(57.3%)B期和33例(40.2%)C期。组织学上,腺癌占70.7%,黏液癌占20.7%,其他占8.6%。所有这些患者被随机分为两组:试验组和对照组。试验组45例患者接受根治性切除加术后第1天和第2天辅助腔内5-氟尿嘧啶化疗及静脉注射5-氟尿嘧啶化疗。腔内5-氟尿嘧啶剂量为30mg/kg,注入结扎带之间分离出的病变肠段肠腔内。静脉剂量为术后第1天和第2天给予10mg/kg。对照组37例患者仅接受根治性切除。采用寿命表法计算生存率,结果显示,Dukes' C期患者中,试验组5年生存率为61.8%,对照组为27.3%(P<0.05)。此外,试验组肝转移少于对照组。随机试验结果表明,辅助腔内5-氟尿嘧啶化疗可能是提高晚期结直肠癌根治性切除效果及预防肝转移的重要方法。建议进一步开展临床研究。