| ObjectiveTo investigate the short-term efficacy of intraperitoneal hyperthermic perfusion chemotherapy for colorectal cancer patients with high risk factors of peritoneal metastasis on immune function,tumor markers,perioperative complications and adverse reactions and to explore the peritoneal peritoneal hyperthermic perfusion chemotherapy for colorectal cancer patients with peritoneal metastasis after palliative resection on occurrence of operative complications,distant organ metastasis and long-term survival.Methods1)Clinical data about 256 cases with colorectal cancer and high risk factors of peritoneal metastasis who received anterior resection from January 1,2016 to December 31,2017 were retrospectively analyzed.Of the 256 cases,112 patients who received intraperitoneal hyperthermic perfusion chemotherapy combined with intravenous chemotherapy after operation were chosen as the observation group and 144 patients who received intravenous chemotherapy alone as the control group.The levels of inflammatory factors,T lymphocyte ratio,tumor markers,perioperative complications and side effects were compared between the two groups.2)Clinical data about 63 cases with colorectal cancer and peritoneal metastasis who received palliative resection from January 1,2015 to June 31,2017 were retrospectively analyzed.Of the 63 cases,37 patients who received intraperitoneal hyperthermic perfusion chemotherapy after operation were chosen as the observation group and 26 patients who didn,t as the control group.The levels of tumor markers,perioperative complications,distant organ metastasis and long-term survival were compared between the two groups.Results1)The baseline data were well matched in two groups.TNF-α,CRP,IL-6 in the observation group were significantly lower than those in the control group during the same period[(62.86±9.13)vs(66.42±11.72);(46.47±7.58)vs(49.31 ± 10.03);(40.27±8.36)vs(43.29±9.66),all P<0.05].The ratio of CD3+,CD4+T lymphocyte and ratio of CD4+ to CD8+ in the observation group were higher than those in the control group after treatment[(71.83±8.61)vs(68.77±9.18);(31.64±4.83)vs(30.01±5.06);(1.17±0.15)vs(1.10±0.19),all P<0.05].There was no significant difference in complications(anastomotic leakage,incision infection,intra-abdominal hemorrhage,intestinal obstruction),the incidence of myelosuppression,vomiting,diarrhea,oral mucositis after chemotherapy and distant metastasis and survival between the two groups(all P>0.05).Local recurrence in observation group was lower than that in control group(0.0%vs 5.6%,P<0.05).2)The baseline data were well matched in two groups.There was no significant difference in perioperative complications and preoperative tumor markers CA19-9,CA-125 and CEA between the two groups,but the levels of CA19-9,CA-125 and CEA in the observation group were lower than those in the control group half a year and one year after operation(all P<0.05).There was no significant difference in lung metastasis between the two groups within 1 year after operation,but the incidence of liver metastasis in the observation group was lower than that in the control group(27.0%vs.53.8%,P<0.05).The survival of the observation group was better than that of the control group,and there was significant difference in survival curve between the two groups(P<0.05).Conclusions1)Intraperitoneal hyperthermic perfusion chemotherapy can reduce the release of inflanunatory factors,improve the immune function of patients with colorectal cancer,reduce local recurrence of tumor,and it does not increase perioperative complications and adverse reactions during chemotherapy.It can be used as an adjuvant therapy for colorectal cancer patients with high risk factors of peritoneal metastasis.2)Intraperitoneal hyperthermic perfusion chemotherapy can delay distant organ metastasis of liver after palliative resection of primary colorectal cancer with peritoneal metastasis to a certain extent without increasing perioperative complications,and improve the survival time of patients.It has good application value. |
PDF Full Text Request