Clinical Analysis Of Hyperthermic Intraperitoneal Chemotherapy Combined With Systemic Chemotherapy In The Treatment Of T4 Colorectal Cancer

Objective This study aims to investigate the clinical efficacy and safety of hyperthermic intraperitoneal chemotherapy combined with systemic chemotherapy in the treatment of T4 colorectal cancer.Methods Retrospective review of 100 patients with T4 colorectal cancer admitted to Yichang Central People’s Hospital from April 2016 to April 2018.Fifty-two patients were given hyperthermic intraperitoneal chemotherapy and systemic chemotherapy after operation as the HIPEC group.Forty-eight patients were given systemic chemotherapy after operation as the control group.Clinical efficacyprogress-free survival time,the incidences of adverse reaction of chemotherapy and postoperative complications,tumor markers level of the two groups were compared.Results There were no statistically significant differences in gender,age,body mass index,location of tumors,pathological type,lymphatic metastasis,invasion of nerve or vascular system,and surgical methods between the two groups(P>0.05).The data were comparable.The median progression-free survival time in HIPEC group was significantly longer than that in control group(30.0vs.25.0 months,P=0.046).Further stratified analysis found that the median progression-free survival time of T4 a stage patients in two groups was similar(30.0vs.29.0 months),with no statistically significant difference(P>0.05),while median progression-free survival time of T4 b stage patients in HIPEC group was significantly longer than that in T4 b patients of control group(29.0vs.17.0 months,P=0.030),with significant statistically difference(P<0.05).The incidences of adverse reaction of chemotherapy in HIPEC group,including diarrhea,bone marrow suppression,liver and kidney function injury,were similar to control group(P>0.05),but the incidences of nausea and vomiting in HIPEC group were higher than that in control group(P<0.05).The incidences of postoperative complications between the two groups,including abdominal pain,fever,hypoproteinemia,intestinal obstruction,intra-abdominal hemorrhage,incision dehiscence,intra-abdominal infection,hypocalcemia,hyponatremia,hypokalemia,were not significant differences(P>0.05).But the incidence of abdominal distension in HIPEC group was higher than that in control group,the difference was significant(P<0.05).There was no significant difference in the level of preoperative tumor markers(CEA,CA199,CA724)between the two groups(P>0.05).The level of CEA and CA199 between the two groups in the sixth chemotherapy treatment,was still no significant difference(P>0.05).Compared with the level of CA724 in the sixth chemotherapy treatment,control group was significantly higher than that in the HIPEC group,and there was significant difference between the two groups(P<0.05).Conclusion Compared with simple systemic chemotherapy,hyperthermic intraperitoneal chemotherapy combined with systemic chemotherapy can effectively control the peritoneal recurrence and metastasis of stage T4 b colorectal cancer.The short-term clinical efficacy is significant.