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晚期低位直肠癌在临床上并不少见,因其位置的特殊性,造成一部分患者在尚未发生远处血行或淋巴转移时,就已经丧失了手术切除的机会。而全身化疗中,药物在肝脏的快速代谢及对人体的毒性反应影响了治疗效果。这部分病人在应用标准的5-Fu与四氢叶酸方案的治疗,中位生存期为9.7~11.2个月。作者采用手术中经直肠上动脉置管、皮下埋泵的方法,通过泵注入同类药物进行化疗,使药物在肿瘤局部浓度高,减少了外周静脉给药在肝脏的代谢环节,同时也减轻了药物的全身毒性反应,使病人更易耐受治疗,疗效更佳,本组共治疗21例病人,生存期达22~26个月,明显优于国外同类治疗报道。
Late low rectal cancer is not uncommon in clinical practice. Due to its unique location, some patients have lost the chance of surgical resection without distant blood or lymphatic metastasis. In systemic chemotherapy, the rapid metabolism of the drug in the liver and its toxic effects on the human body affect the therapeutic effect. This group of patients was treated with standard 5-Fu and tetrahydrofolate regimens and the median survival was 9.7 to 11.2 months. The authors used intraoperative transrectal arterial catheterization and subcutaneous pumping methods to inject chemotherapy into the same type of drug through a pump. This resulted in a high local concentration of the drug in the tumor, which reduced the metabolic link in the liver for peripheral intravenous administration and also reduced the drug. The systemic toxic reaction made the patient more tolerant to treatment, and the efficacy was better. In this group, 21 patients were treated and the survival period was 22 to 26 months, which was significantly better than that of similar foreign reports.