Evaluation Of Pre-operation Neoadjuvant Chemotherapy With 5-Fluorouracil Sustained Release For Implant Injected In Rectal Submucosal In The Patients With Colorectal Cancer

Objective In order to evaluate the effect of a neoadjuvant chemotherapy with 5-Fluorouracil Sustained Release for Implant (5-FuSRI)injected in rectal submucosal in the patients with colorectal cancer. The effect of this treatment was judged by 5-Eu concentration and distribution in blood and tissue, cellular degeneration, necrosis degree, apoptotic index (Al), the positive rate of proliferating cell nuclear antigen (PCNA) expression. Methods 25 patients with colorectal cancer were divided into two groups. Group I (n=13),patients underwent the treatment of submucosal multiple 5-FuSRI with the simple dose of 500mg/body before 72 hours of operation . Group II (n=12), patients did not received any chemotherapy before operation . The level of 5-Eu in peripheral veins, portal veins and in the tissues of tumor and para-tumor was studied. 5-Eu was detected by high performance liquid chromatography (HPLC) at 24, 48, 72 hours. Tumor biopsy before 5-FuSRI injected and after tumor removed was done for pathologic examination. Apoptotic cells were identified by HE stain section. The expression of PCNA was examined by inimunohistochemical staining. The program of SPSS (10.1) was used. Data were presented as means ?standard deviation (S.D.), and the significance of differences was determined by Student抯 t test and a one-way analysis of variance Results In group I , the serum concentration of 5-Eu in peripheral veins at 24,48 and 72 hours were 1.832?0.136ug/ml, 0.195 ?.088ug/ml and 0.219?0.162ug/ml respectively. The concentration of 5-Fu in portal veins, tumor tissues and para-tumor tissues at 72 hours were 0.418?0.261ug/ml, 1.478?1.333ug/g and 0.646 ?0.600ug/g respectively. The cellular degeneration and necrosis due to the chemotherapy was found in 11 cases (11/13=85%). Post- chemotherapy Al (3.623 ?1.235) was higher than that before (1.200 ?0.398) chemotherapy (P<0.05), and post-chemotherapy P1 (46 ?7.22) was lower than that before (56.85 ?6.48) chemotherapy (P<0.01). No side effect was found in all patients. Conclusion The treatment of rectal submucosal multiple implant of 5-FuSRI presents a significant pharmacokinetic, pharmacodynamic advantage and reasonability in preventing post-operative recurrence, metastasis of colorectal cancer.