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[目的]探讨不可切除的结直肠癌肝转移患者的治疗方法。[方法]97例不可切除的结直肠癌肝转移患者分为治疗组47例和对照组50例。对照组结直肠癌切除术后2周开始FOLFOX方案全身化疗。治疗组在结直肠癌切除术中及术后经门静脉和肝动脉化疗泵行5-Fu肝脏局部灌注化疗,全身化疗和其余治疗同对照组。[结果 ]两组治疗后病灶数目和大小均减小,CEA、CA199均降低,两组差异显著(P<0.05)。治疗组中位生存时间33.7个月,1、3、5年生存率分别为81.2%、42.8%和10.6%,对照组中位生存时间21.8个月,1、3、5年生存率分别为64.0%、19.7%和0,两组差异显著(P<0.05);两组术后并发症及不良反应发生率无明显差异(P>0.05)。[结论]经门静脉和肝动脉灌注化疗对于不可切除的结直肠癌肝转移瘤是安全有效的,可以延长患者的生存期,改善患者预后。
[Objective] To investigate the treatment of unresectable colorectal cancer patients with liver metastasis. [Method] 97 patients with unresectable colorectal cancer with liver metastases were divided into treatment group (n = 47) and control group (n = 50). In the control group, FOLFOX regimen started systemic chemotherapy two weeks after resection of colorectal cancer. In the treatment group, 5-Fu liver was infused through the portal vein and hepatic artery pump in the course of resection of colorectal cancer and postoperative chemotherapy. The systemic chemotherapy and the rest of the treatment were the same as the control group. [Results] The number and size of lesion in both groups decreased, CEA and CA199 decreased, the difference between the two groups was significant (P <0.05). The median survival time was 33.7 months in the treatment group and 81.2%, 42.8% and 10.6% in the 1, 3 and 5 years respectively. The median survival time in the control group was 21.8 months. The 1, 3 and 5-year survival rates were 64.0 %, 19.7% and 0 respectively. The difference between the two groups was significant (P <0.05). There was no significant difference in postoperative complications and adverse reactions between the two groups (P> 0.05). [Conclusion] The transcatheter arterial chemoembolization through the portal vein and hepatic artery is safe and effective for unresectable colorectal cancer liver metastases, which can prolong the survival of patients and improve the prognosis of patients.