出国医疗

Ⅰ~Ⅲ期结直肠癌患者围手术期肝脏局部化疗对

来源:再生之旅    时间:2014-01-07 11:18  浏览次数:

AbstractBackgroundand purposeThe morbility of CRC has increased gradually in recent years. The primary modality of treatment is surgery, but liver tumor metastases is still a big problem. Systemic chemotherapy has no apparent effect on the prevention of liver tumor recurrence in CRC. Hence, a continuous infusion of cytotoxic drugs into the liver via the portal vein or hepatic artery during the perioperative period has been proposed to reduce liver metastases after surgery. This study evaluated the effects of prophylactic regional liver chemotherapy during the perioperative period on survival and prevention of liver metastases in the patients with colorectal cancer (CRC).

MethodsA comprehensive search of relevant databases, including MEDLINE, EMBASE was conducted. Trials were divided into two subgroups according to therapy type. The rates of mortality and liver metastases were analyzed using a fixed-effects model. A statistical analysis was performed with Review Managers software (RevMan 5.0.23).  

Results

Metaanalysis results showed statistically significant differences in terms of survival in patients receiving perioperative hepatic artery infusion (HAI) chemotherapy in comparison to patients receiving surgery alone (pooled relative risk P=0.46, 95% CI: 0.31-0.69). Liver metastases rate also displayed a statistically significant difference (pooled relative risk P=0.44, 95% CI: 0.28-0.68). There were no statistically significant differences in terms of survival and liver metastases rate in the patients receiving perioperative portal vein infusion (PVI) chemotherapy in comparison to the patients receiving surgery alone (pooled relative risk P=0.98, 95% CI: 0.89-1.09; pooled relative risk P=0.86, 95% CI: 0.72-1.02, respectively).  ConclusionAs one of the methods of regional liver chemotherapy, HAI may be able to reduce liver metastases in patients with advanced CRC

【摘要】 背景和目的:

结肠癌发病率逐年上升。手术治疗是主要方法,但是术后肝转移依旧是普遍现象。全身化疗对于肝转移预防作用不大。所以,围生期间,通过门静脉或肝动脉灌注细胞毒性药物来降低术后肝转移率。这就是研究者探究局部化疗对生存率及肝转移预防的影响。

方法:采用 相关数据库综合搜索,包括MEDLINE, EMBASE 数据库,然后根据治疗类型分为两个亚组,选用RevMan 5.0.23软件分析发生率及肝转移。结果:围手术期肝动脉灌注与单纯手术比较的Meta 分析结果显示:肝动脉灌注患者5年生存率相对危险度为0.46%

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