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目的探讨经脐静脉置管门静脉灌注化疗防治结肠癌肝转移的效果。方法结肠癌肝转移的患者61例随机分为两组,均先行结肠癌原发病灶和肝转移癌肿切除术。治疗组31例,术中经脐静脉至门静脉置管放置化疗泵,术后灌注化疗;对照组30例,术后经静脉行全身化疗。结果随访至1年时,治疗组再次出现肝内转移率13.7%,明显低于对照组的41.1%(P<0.05)。治疗组1年生存率为72.4%,明显高于对照组的41.3%(P<0.05)。治疗组肝功能损伤的发生率明显高于对照组(45.2%vs.20.0%)(P<0.05)。两组胃肠道不良反应、骨髓抑制及末梢神经毒性的发生率相仿(P>0.05)。结论经脐静脉置管门静脉灌注化疗能有效降低结肠癌肝转移术后肝内复发率,延长患者生存期。
Objective To investigate the effect of intravesical instillation of intravenous infusion of umbilical vein on the prevention and treatment of liver metastasis of colon cancer. Methods Sixty-one patients with hepatic metastasis of colon cancer were randomly divided into two groups. All of them were performed primary resection of primary colon cancer and hepatic metastasis. In the treatment group, 31 cases were treated by catheterization of the umbilical vein to the portal vein during operation, and chemotherapy was given after the operation. In the control group, 30 cases were treated with systemic chemotherapy through the vein. Results At 1 year follow-up, the intrahepatic metastasis rate was 13.7% in the treatment group, which was significantly lower than that in the control group (41.1%, P <0.05). The 1-year survival rate was 72.4% in the treatment group, which was significantly higher than that in the control group (41.3%, P <0.05). The incidence of liver injury in the treatment group was significantly higher than that in the control group (45.2% vs. 20.0%, P <0.05). Gastrointestinal adverse reactions, bone marrow suppression and peripheral neurotoxicity were similar in both groups (P> 0.05). Conclusions Transcatheter arterial infusion chemotherapy through umbilical vein can effectively reduce the intrahepatic recurrence rate and prolong the survival of patients with colon cancer after liver transplantation.