| The cancer of gastrointestinal tract is the most common malignant tumor in enteron. Advanced cancer accounts for the vast majority. Even with radical surgery, more than half patients still have peritoneum-metastasis or recurrence,which is a major cause of cancer-related mortality. In order to reduce gastrointestinal tumor recurrence and metastasis rate and improve survival, We have achieved consensus on convention- alchemotherapy for the postoperative patients in advanced gastrointestinal tumor. Presently,Chemotherapy for colorectal carcinoma is more mature, but the effect still needs to be improved. Nowadays, There is no uniform chemotherapy for gastric tumor, Kinds of chemotherapies in china and abroad have achieved good recent effect, but the long-term effect is not encouraging.In recent years, because of the safety, effectiveness, Significant pharmacokinetic advantages and its synergistic effectiveness with intravenous chemotherapy, the CHPPC combined with intravenous chemotherapy has been paid more attention on prevention or treatment of postoperative recurrence or metastasis, and has achieved exciting results. we has no uniform standards for this combined chemotherapy at home and abroad, which is still at the exploratory stage. The purpose of this study is to explore the advantages, short-term efficacy and toxicity of the combined chemotherapy in the treatment of advanced gastrointestinal cancer.This article carried out Open-control study focused on 83 patients who seeked medical services in our hospital from 2007 to 2009 because of advanced gastrointestinal tumors, 45 cases of treatment group with combined chemotherapy, 38 cases of control group with intravenous chemotherapy. Every 2 weeks as a cycle, we evaluated the efficacy after 3 cycles chemotherapy ,and respectively observed clinical response after treatment, year follow-up survival rate and safety. Results are as follows: (1) analysis of 83 patients'clinical data, we find that the overall rate of liver metastasis accunts for 40.9%, abdominal lymph node metastasis accunts for 75.8%. (2)The total response rate (RR) of treatment group was 64.4%,(CR+PR+SD)% was 86.7%, and its CR 15.6%, PR 48.9%, SD 22.2%, PD 13.3%, The total RRof control group was 31.6%,(CR+PR+SD)% was 57.9%,and its CR 7.9%,PR 23.7%,SD 26.3%,PD 42.1%. The total RR %and (CR+PR+SD)% of the two groups was significant statistical difference (p<0.01). Respectively comparing gastric cancer and colorectal cancer, there was more significant difference between the two groups (p<0.05). RR in colorectal cancer, treatment group was 70.6%, control group was 33.3%, more significant difference between the two groups(p<0.05). RR rate of the treatment of ascites was 81.3% in treatment group and 26.7% in control group, the difference was statistically significant (p<0.05), 1-year survival rate was no significant difference between treatment group and control group. In addition, Comparing the RR of untreated and re-treated in treatment group, we fined the RR was 77.4% in untreated group and 35.7% in re-treated group, the difference was statistically significant (p<0.05). Comparing the RR of Stageâ…¢andâ…£in treatment group, we fined the RR was 75% in Stageâ…¢group and 58.6% inâ…£group, the difference was no statistically significant(p>0.05). (3)Comparing the rate of adverse reactions between treatment group and control group, the difference was no statistically significant (p>0.05), the main adverse reaction was digestive tract reation, bone marrow inhibitors, peripheral nerve toxicity, liver dysfunction. conclusions: (1)Combined-chemotherapy is better than intravenous chemotherapy,it improved the RR% and (PR+CR+SD)%;tthere is no difference in 1-year survival rate. (2)The efficacy in untreated group is better than re-treated group. And there is no difference between Stageâ…¢andâ…£. (3) Combined-chemotherapy is better than intravenous chemotherapy on the treatment of ascites.(4)Combined-chemotherapy did not increase adverse reactions, there is a few CHPP-related adverse reactions, and the degree is light, all patients can tolerate it. CHPP is a desirable comprehensive treatment measures and can be widely used in clinical. |
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