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目的探讨全直肠系膜切除(TME)加髂内动脉局部灌注及全身化疗在直肠癌治疗中的作用。方法将193例直肠癌患者随机分为两组:观察组98例,在TME术后应用髂内动脉置泵化疗及全身化疗;对照组95例,在TME术后行全身化疗。观察并比较两组的术后局部复发率、远处转移率和生存率。结果术后1,3,5年局部复发率,观察组分别为0%(0/98),2.5%(2/81),3.8%(3/79);对照组分别为1.1%(1/95),11.4%(9/79),16.2%(11/68)。术后1,3,5年远处转移率:观察组分别为1.1%(1/98),6.2%(5/81),12.7%(10/79);对照组分别为2.1%(2/95),24.1%(19/79),30.9%(21/68)。两组1年生存率均为100%,3年生存率观察组为79.0%(64/81),对照组为57.0%(45/79);5年生存率观察组为73.4%(58/79),对照组为52.9%(36/68)。除1年局部复发率、远处转移率及生存率外,两组3,5年术后局部复发率及3,5年远处转移率和术后3,5年生存率各相应时间段比较,差异均有统计学意义(P<0.05)。结论TME加髂内动脉灌注化疗及全身化疗可显著降低直肠癌患者局部复发率及远处转移率,提高患者生存率,是治疗直肠癌的有效模式。
Objective To investigate the role of total mesorectal excision (TME) plus intra-arterial local perfusion and systemic chemotherapy in the treatment of rectal cancer. Methods 193 patients with rectal cancer were randomly divided into two groups: 98 patients in the observation group, internal iliac artery pump therapy and systemic chemotherapy after TME; 95 patients in the control group received systemic chemotherapy after TME. The postoperative local recurrence rate, distant metastasis rate and survival rate were observed and compared. Results The local recurrence rate at 1, 3, and 5 years after operation was 0% (0/98), 2.5% (2/81), and 3.8% (3/79) in the observation group and 1.1% in the control group (1/1). 95), 11.4% (9/79), 16.2% (11/68). The rate of distant metastasis at 1, 3, and 5 years after surgery was 1.1% (1/98), 6.2% (5/81), and 12.7% (10/79) respectively in the observation group and 2.1% in the control group (2/ 95), 24.1% (19/79), 30.9% (21/68). The 1-year survival rate was 100% in both groups, and the 3-year survival rate was 79.0% (64/81) in the observation group and 57.0% (45/79) in the control group; 73.4% (58/79) in the 5-year survival rate observation group. ), the control group was 52.9% (36/68). Except for 1 year local recurrence rate, distant metastasis rate and survival rate, the local recurrence rate, 3 and 5 year distant metastasis rate and 3 to 5 year survival rate after operation in the 3 and 5 year groups were compared between the two groups. The differences were statistically significant (P<0.05). Conclusion TME plus internal iliac arterial infusion chemotherapy and systemic chemotherapy can significantly reduce the local recurrence rate and distant metastasis rate of patients with rectal cancer, and improve the survival rate of patients. It is an effective model for the treatment of rectal cancer.