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目的探讨内镜下化疗粒子植入术治疗晚期直肠癌的具体方案、治疗效果及安全性。方法将54例晚期直肠癌患者,分为四组:对症治疗组,口服希罗达化疗组,内镜下5-氟尿嘧啶(5-Fu)化疗粒子植入术组,口服化疗同化疗粒子植入术联合治疗组。知情同意后,分行不同的治疗方案,观察并分析抑瘤疗效,肠梗阻的发生率,1、2年生存率,治疗相关的不良反应及并发症。结果内镜下化疗粒子植入术能较好地被耐受,无明显不良反应及并发症发生。粒子植入术治疗后,直肠癌的临床受益患者达54.5%,接近口服化疗药物疗效58.8%,且粒子植入治疗组及联合口服化疗组中,肠梗阻的发生率明显降低(27.3%,20.0%)。较之对症治疗组,口服化疗组、粒子植入组及联合治疗组中直肠癌患者的2年生存率提高不明显(35.3%,36.4%,40.0%),但1年生存率(64.7%,63.6%,80.0%)有明显的提高。结论对于晚期直肠癌患者,内镜下化疗粒子植入术是一种操作简单、耐受性好、不良反应及并发症较少、具有一定疗效的治疗方法。
Objective To investigate the specific plan, efficacy and safety of endoscopic chemotherapy for advanced colorectal cancer. Methods 54 patients with advanced rectal cancer were divided into four groups: symptomatic treatment group, oral Xeloda chemotherapy group, endoscopic 5-fluorouracil (5-Fu) chemotherapy particle implantation group, oral chemotherapy with chemotherapy particle implantation Combined surgery group. Informed consent, the branch of different treatment options, observed and analyzed anti-tumor efficacy, the incidence of intestinal obstruction, 1, 2-year survival rate, treatment-related adverse events and complications. Results Endoscopic chemotherapy particle implantation can be well tolerated, no obvious adverse reactions and complications. After implantation, the clinical benefit of rectal cancer reached 54.5%, which was close to that of oral chemotherapy. The incidence of intestinal obstruction was significantly lower in the group of particle implantation and the combination of oral chemotherapy (27.3%, 20.0 %). Compared with the symptomatic treatment group, the two-year survival rate was not significantly increased (35.3%, 36.4%, 40.0%) in the oral chemotherapy group, the particle implantation group and the combination therapy group, but the 1-year survival rate was 64.7% 63.6%, 80.0%) significantly improved. Conclusion For patients with advanced rectal cancer, endoscopic chemotherapy particle implantation is a simple, well tolerated, adverse reactions and fewer complications, with a certain effect of treatment.