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腹腔内温热灌注化疗对结直肠癌腹腔内复发的防治作用▲
Intraperitoneal hyperthermic perfusion chemotherapy on prevention and treatment of colorectal cancer peritoneal recurrence

微创医学 201603期 页码:333-334+374

作者机构:广西中医药大学第一附属医院胃肠腺体外科,南宁市530023

基金信息:▲基金项目:广西区卫生厅科研课题(编号:Z2010178)
作者简介:庞黎明(1967~),男,研究生,副主任医师,研究方向:腹腔镜结直肠癌治疗。

DOI:DOI:10.11864/j.issn.1673.2016.03.07

  • 中文简介
  • 英文简介
  • 参考文献
目的评价腹腔内温热灌注化疗对结直肠癌术后腹腔内复发的预防效果。方法接受手术切除的50例结直肠癌患者,随机分为温热组及常温组,每组25例。温热组在手术结束后用含氟尿嘧啶(5-FU)0.5 g/L、丝裂霉素(MMC)8 mg/L、奥沙利铂25 mg/L的温热(43℃~45℃)蒸馏水4 000 mL在腹腔灌洗1 h。常温组灌洗药物与温热组相同,灌洗液温度控制在25℃~30℃,给予腹腔灌洗1 h。两组分别于术后1个月、术后2个月再次腹腔灌洗;两组患者均于治疗前、术中、术后1个月、术后2个月应用ELISA法测定外周血IL-2、TNF-α水平。随访比较两组患者的生存率、腹腔内复发率及肝转移发生率。结果与常温组相比,温热组IL-2、TNF-α水平均明显升高,差异有统计学意义(P<0.01);3年生存率升高12.0%,而腹腔内转移率和肝转移发生率分别下降12.0%和8.0%,差异均有统计学意义(P<0.05)。结论腹腔内温热灌注化疗可促进免疫指标(IL-2、TNF-α)水平升高,提高抗肿瘤免疫功能,对结直肠癌术后腹腔内复发的治疗或预防有一定的作用。
ObjectiveTo evaluate the prevention effect of intraperitoneal hyperthermic chemotherapy for peritoneal recurrence after colorectal cancer surgery. MethodsA total of 50 cases with colorectal cancer after surgical resection were randomly divided into normal temperature group and hyperthermia group. Patients in hyperthermia group were given hyperthermic perfusion chemotherapy after surgery,warm(43-45℃) distilled water 4 000 mL containing fluorouracil (5-FU)0.5 g/L, mitomycinC (MMC) 8 mg/L, oxaliplatin 25 mg/L, peritoneal lavage for 1h. Patients in normal temperature group were given with the same chemotherapy drugs, temperature controlled at 25-30℃, peritoneal lavage for 1h. Then Two groups were given peritoneal lavageonce again in 1 months and 2 months after surgery; before treatment, 1 month and 2 months after operation, the level of IL-2 and TNF-α were measured by ELISA method. Survival rates, intraperitoneal recurrence rate and the incidence of liver metastasis were compared. ResultsCompared with the normal temperature group, the levels of IL-2, TNF-α were significantly increased, the difference was statistically significant (P<0.01); 3-year survival rate increased by l2.0%, while intra-abdominal metastasis rate and liver metastasis rate decreased by l2.0% and 8.0%, respectively, the differences were statistically significant (P<0.05). ConclusionIntraperitoneal hyperthermic perfusion therapy could increases immune parameters (IL-2, TNF-α) levels, improve the anti-tumor immunity of patients, within the abdominal cavity of colorectal cancer recurrence after treatment or prevention of a certain role.

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