论文部分内容阅读
目的探讨动脉内置泵灌注化疗对晚期结直肠癌的疗效。方法对46例不能切除的晚期结直肠癌采用动脉置泵灌注化疗的新辅助化疗(MEH方案):5-Fu 500 mg/m2,丝裂霉素(MMC)6 mg/m2,羟基喜树碱(HPT)20 mg/m2,每周1次,2周1个疗程,休息3周后重复,共2~3个疗程。结果完全缓解(CR)2例,部分缓解(PR)28例,稳定(SD)15例,进展(PD)1例。有效率(CR+PR)为66.2%,PR 28例中手术切除15例,占53.6%。术后病理检查发现癌细胞均有不同程度的核固缩、碎裂、胞浆凝固、变性,细胞间质水肿、纤维增生、炎细胞浸润,血管内膜增厚、血栓形成。结论动脉内灌注的新辅助化疗作为晚期直肠癌综合治疗的一部分,对改善病期,使不可能手术患者变为可能手术,提高手术切除率可以发挥重要作用,并使癌肿组织学形态发生明显改变。
Objective To investigate the effect of intra-arterial infusion pump chemotherapy on advanced colorectal cancer. Methods Forty-six patients with unresectable advanced colorectal cancer undergoing neoadjuvant chemotherapy (MEH regimen) were treated with 5-Fu 500 mg / m2, MMC 6 mg / m2, hydroxycamptothecin (HPT) 20 mg / m2, once a week, 1 week for 2 weeks and 3 weeks for rest after a total of 2 to 3 courses. Results Two cases were complete remission (CR), 28 were partial remission (PR), 15 were stable (SD) and one was progressive (PD). The effective rate (CR + PR) was 66.2%. PR 28 cases of surgical resection in 15 cases, accounting for 53.6%. Postoperative pathological examination found that the cancer cells have different degrees of nuclear pyknosis, fragmentation, cytoplasmic coagulation, degeneration, interstitial edema, fibrosis, inflammatory cell infiltration, intimal thickening, thrombosis. Conclusion Intra-arterial neoadjuvant chemotherapy as part of the comprehensive treatment of advanced rectal cancer, to improve the stage of disease, making it impossible for surgery in patients with surgery, improve the surgical resection rate can play an important role, and make obvious histological appearance of cancer change.