摘要
目的：分析细胞减灭术（cRs）加术中腹腔热灌注化疗术（HIPEC）对结直肠癌腹膜转移癌的疗效及安全性。方法：课题设计为回顾性病例对照研究，收集结直肠癌腹膜转移癌（CRCPC）患者资料，按临床病理参数匹配原则，分为CRS组（CRS＋术后全身化疗）29例，HIPEC组（CRS＋HIPEC＋术后全身化疗）33例。分析两组的总体生存期（os）及严重不良事件（SAE）。结果：两组患者临床病理学特征均衡可比，术中PCI评分及器官，腹膜切除情况相似。两组中位随访时间分别为41．9个月（6．5～110．0个月）和32．0个月（10．5～95．9个月），OS分别为8．5个月（95％CI：4．9—12．1个月）和14．5个月（95％CI：11．9～17．1月）（P=0．007）。术后30天内CRS组3例发生SAE，HIPEC组9例（P=0．126）。多因素分析显示，HIPEC、CC0～1分、术后化疗周期≥6个周期为改善生存的独立预后因素。结论：CRS＋HIPEC可改善CRCPC患者生存期，SAE无显著增加，安全性可接受。
Objective： To evaluate the efficacy and safety of cytoreductive surgery （CRS） in conjunction with hyperthermic intra- peritoneal chemotherapy （HIPEC） for treating patients with peritoneal carcinomatosis （PC） from colorectal cancer （CRC）. Methods： A total of 62 CRC patients with complication of PC were divided into the CRS group, namely, Group One （n=29, CRS and systemic adju- vant chemotherapy） and the CRS ＋ HIPEC group, namely, Group Two （n=33, CRS＋HIPEC）. The primary end point of the study was overall survival （OS） and the secondary end point was serious adverse events （SAE）. Results： Patients＇ clinicopathologic characteris- tics, peritoneal carcinomatosis index, and completeness of cytoreduction therapy were well balanced and comparable between the two groups. The median follow-up was 41.9 mo （6.5 mo to 110.0 too） in Group One and 32.0 mo （10.5 mo to 95.9 mo） in Group Two. The median OS was 8.5 mo （95% CI： 4.9 mo to 12.1 mo） in Group One and 14.5 mo （95% CI： 11.9 mo to 17.1 mo） in Group Two （P= 0.007）. Within 30 days after the surgery, SAE occurred in 3 of the 29 patients in Group One, and 9 of the 33 patients in Group Two （P= 0.126）. Multivariate analysis revealed that HIPEC, CC0-1 score, and chemotherapy over six cycles were the independent factors for OS improvement. Conclusion： The CRS＋HIPEC method improves the OS of patients with PC from CRC, suggesting an acceptable safety.
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2013年第16期979-983,共5页
Chinese Journal of Clinical Oncology
基金
国家自然科学基金创新群体项目(编号:20921062)
中央高校基本科研业务费专项资金资助(编号:2012303020212)
教育部博士学科点专项科研基金(编号:20120141110042)资助~~
关键词
结直肠癌
细胞减灭术
腹腔热灌注化疗
腹膜癌
colorectal cancer, cytoreductive surgery, hyperthermic intra-peritoneal chemotherapy, peritoneal carcinomatosis
