Penna C, Nordlinger B
Department of Gastrointestinal Surgery, Hospital Saint-Antoine, Paris, France.
Eur J Cancer. 1996 Jun;32A(7):1117-22. doi: 10.1016/0959-8049(96)00044-5.
Adjuvant chemotherapy with 5-fluorouracil (5-FU) and levamisole administered intravenously for 1 year has proved to be effective after curative surgical resection of Dukes' stage C colon carcinomas. Locoregional chemotherapy aims at delivering drugs directly into the abdominal cavity or the liver using either intraperitoneal or intraportal route of administration. Theoretically, these routes of administration have several advantages. The drugs can be delivered at a high dose concentration to the most common site of recurrence (i.e. peritoneum and liver) with decreased systemic toxicity. This article reviews the present status of intraportal and intraperitoneal chemotherapy as adjuvant postoperative treatment for colorectal carcinoma with special attention to the results of prospective randomised trials. Some positive results confirm that both route of administration represent promising methods for adjuvant chemotherapy. However, currently there are insufficient data on which to make a clear-cut conclusion on real benefits. New trials are currently in progress to test new modalities using different drugs or different drug combinations, using both locoregional and systemic treatments, and may prove to be more effective than systemic chemotherapy alone in the adjuvant treatment of colorectal cancers.
已证实，对于 Dukes' C 期结肠癌患者，在根治性手术切除后静脉注射 5-氟尿嘧啶（5-FU）和左旋咪唑进行 1 年的辅助化疗是有效的。局部区域化疗旨在通过腹腔内或门静脉给药途径将药物直接输送到腹腔或肝脏。从理论上讲，这些给药途径有几个优点。药物可以高剂量浓度输送到最常见的复发部位（即腹膜和肝脏），同时降低全身毒性。本文回顾了门静脉和腹腔内化疗作为结直肠癌术后辅助治疗的现状，并特别关注前瞻性随机试验的结果。一些积极的结果证实，这两种给药途径都是辅助化疗的有前景的方法。然而，目前尚无足够的数据来明确其实际益处。目前正在进行新的试验，以测试使用不同药物或不同药物组合的新模式，同时采用局部区域和全身治疗，可能证明在结直肠癌的辅助治疗中比单纯全身化疗更有效。
