Résumé
Objective:To investigate the safety and effect of complete mesocolie excision (CME) combined with arterial infusion chemotherapy (AIC) and intra-peritoneal interstitial sustained-release chemotherapy (IPISRC). Methods:A total of 104 patients were classified under the experimental group and underwent CME combined with AIC and IPISRC. The other 98 patients were classified un-der the control group and only received radical surgery. Pre-and post-operative blood routine examinations, as well as liver and kidney function tests, were conducted for both groups. Post-operative adverse reactions and incidence of complications were recorded. Cancer and para-neoplastic tissues were sampled in experimental group. The post-surgery 5-fluorouracil (5-FU) concentration in the drainage fluid as well as those in the peripheral blood , were determined. Three-year follow-ups were conducted, during which the local recur-rence rate, liver metastasis, progression-free survival rate, and total survival rate were recorded. Results: No significant differences were found in the white blood cell count, hemoglobin count, liver and renal functions of the patients before and after the surgery, and rate of adverse reaction and complications between the two groups after surgery (P>0.05). In experimental group , the 5-FU concentra-tion was significantly higher in the cancer tissues than in the para-neoplastic tissues . The 5-FU concentration in experimental group was also significantly higher in the intra-peritoneal drainage liquid and reached its peak in the peripheral blood on day 3 post-surgery . Local recurrence and liver metastasis rates were significantly lower in experimental group than those in control group, whereas the pro-gression-free and three-year overall survival rates were significantly higher in experimental group than in control group (P<0.05). Con-clusion:The tharepy of pations of experimental goup is safe and effective. This method significantly improves the progression-free and three-year survival rates of the patients as well as significantly reduces the local recurrence and liver metastasis rates of colon cancer.
Résumé
Background and purpose:In China, incidence of gastric cancer is high but early diagnosis is low and treatment results remains poor.The role of neoadjuvant chemotherapy for patients has been explored.In this study, we evaluated the effects and safety of preoperative intra-arterial infusion chemotherapy(PAIC) for advanced gastric cancer.Methods:One hundred and five patients with clinic stage-Ⅱ above advanced gastric cancer were submitted to preoperative intra-arterial infusion chemotherapy using the Seldinger technique.The regimen consisted of 5-FU 750 mg/m2, MMC 10 mg/m2, and DDP 60 mg/m2.Seven to ten days after the PAIC, all 105 patients received operation.Other 95 patients underwent surgery directly as control group.The responses by the tumor lesion and chemotherapy toxicity were observed.The long term survival rate were also evaluated.Results:Pathological examination showed that the tumor cells had changed by chemothrapy.Common adverse effects of PAIC were grade Ⅰ-Ⅱ gastrointestinal discomfort and bone marrow depression.No gastric rupture had occurred.Ninety-one cases(86.6%) underwent curative resection.The 1, 3, and 5-year survival rate was 96.2%, 68.6%, and 52.4% respectively.Among 95 patients with control group, sixty-five cases(68.6%) underwent curative resection.1,3,and 5-year survival rates were 88.4%,38.9% and 28.4%,respectively.Conclusion:PAIC is an effective, and safety chemotherapeutic treatment for advanced gastric cancer.It can affer treatment downstage of disease and enhances resectability.It may also improve the prognosis of advanced gastric cancer.