Intraoperative Chemotherapy with a Novel Regimen Improved the Therapeutic Outcomes of Colorectal Cancer
Intraoperative Chemotherapy with a Novel Regimen Improved the Therapeutic Outcomes of Colorectal Cancer
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新型疗法的术中化疗改善了结直肠癌的治疗效果
DOI：
10.7150/jca.35450
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发表时间：
2019-01-01
影响因子：
3.9
通讯作者：
Zhou, Xinke
中科院分区：
文献类型：
--
作者：
Liu, Zhihua;Zou, Yifeng;Zhou, Xinke
背景：本研究旨在评估一种由羟基喜树碱、肿瘤坏死因子（TNF）、5-氟尿嘧啶（5-FU）和亚叶酸钙（CF）组成的新型术中化疗（IOC）方案对结直肠癌（CRC）预后的疗效。方法：对551例行手术切除的结直肠癌患者进行评价。其中术后辅助化疗247例，术中化疗193例。在接受化疗的结直肠癌患者中，52例患者同时接受了术后辅助化疗和术中化疗。收集患者的年龄、性别、分期、分化、淋巴结转移、手术病理分期、肿瘤位置、肿瘤大小、无复发生存期等特征。结果：与其他临床协变量无关，CRC治疗的IOC与更有利的生存预后相关（HR, 0.30, 95%CI, 0.19-0.48， P<0.001）。接受IOC治疗的CRC患者比未接受IOC治疗的患者在手术期间存活时间更长（P<0.0001, Kaplan-Meier log rank）。同时，Kaplan-Meier分析表明，同时接受IOC和POC的患者比仅接受POC的患者存活时间更长：II期和III期患者（P=0.0001, Kaplan-Meier log rank）， II期患者（P=0.02, Kaplan-Meier log rank），以及III期患者（P=0.046, Kaplan-Meier log rank）。结论：新方案术中化疗可提高结直肠癌的治疗效果，改善结直肠癌患者的预后。
Background: This study sought to evaluate the efficacy of a novel intraoperative chemotherapy (IOC) regimen that consists of hydroxycamptothecin, tumor necrosis factor (TNF), 5-fluorouracil (5-FU), and calcium folinate (CF) on the outcomes of colorectal cancer (CRC). Methods: In total, 551 CRC patients who had undergone surgical resection were evaluated. Among these patients, 247 were treated with postoperative adjuvant chemotherapy, and 193 were treated with intraoperative chemotherapy. Of the CRC patients who underwent chemotherapy, 52 were treated with both postoperative adjuvant chemotherapy and intraoperative chemotherapy. Patients' characteristics, including age, sex, stage, differentiation, lymph node metastasis, surgical-pathological staging, tumor location, tumor size, and relapse-free survival, were collected. Results: IOC for CRC therapy was associated with a more favorable survival prognosis (HR, 0.30, 95%CI, 0.19-0.48, P<0.001) independent of other clinical covariates. CRC patients treated with IOC survived longer than patients who were not treated with IOC did during surgery (P<0.0001, Kaplan-Meier log rank). Meanwhile, a Kaplan-Meier analysis demonstrated that individuals who received both IOC and POC survived longer than patients who received only POC: for stage II and stage III patients (P=0.0001, Kaplan-Meier log rank), stage II patients alone (P=0.02, Kaplan-Meier log rank), and stage III patients alone (P=0.046, Kaplan-Meier log rank). Conclusions: The therapeutic effects of colorectal cancer by intraoperative chemotherapy with a novel regimen were enhanced, which improved the prognosis of patients with CRC.