Prospective Randomized Clinical Study Of Fluorouracil Implants Local Chemotherapy With Operation In Combined Therapy Of Thoracic Tumor

Objective: To evaluate the influence of fluorouracil implants localchemotherapy with operation in combined therapy of thoracic tumor includingesophageal cancer,cardia adenocarcinoma and lung cancer patients, The liverand kidney functions,WBC counting,immunity parameter,tumor markerswere detected during perioperative period and the incidence of postoperativecomplications recrudescence, metastasis and survival rate of patients werecompared.Methods:From October2010to February2012,210surgical treatmentof hospitalized patients of esophageal cancer,cardia adenocarcinoma and lungcancer were diagnosed in this study. Each group of esophageal cancer,cardiaadenocarcinoma and lung cancer patients were divided into observation groupand control group randomly. On admission,all cases made routine systeminspection. All patients received radical operation if without operativecontraindication. The observation group was implemented with300mg to600mg of fluorouracil implants during operation, on tumor bed and operativeraw surface where was involved and/or involved dubiously before radicaloperation's finish. While radical surgery only served as controls. Thepostoperative treatment of two groups was the same. The liver and kidneyfunction,WBC counting were detected on different time,including on the1stday preoperative and the1st,7stdays postoperative respectively in all patientsand immune parameters of NK cell and T cells,serum tumor markers levelswere compared between two groups. Furthermore to compare whether therewas obviously disparity between two groups of the incidence rates ofpostoperative complication,local recurrence,distant metastasis and survival.Based on the comparisons,to evaluate the effieieney and safty of localchemotherapy with operation in combined therapy of thoracic tumor. Results: White blood cell were different preoperative and postoperative(P <0.05), but there was no significant difference of two groups for esophagealcancer,cardia adenocarcinoma and lung cancer patients (P＞0.05). Theperioperative changement of ALT,AST,BUN and CR were no significantdifferences between two groups (P>0.05). There were No significantdifferences of immunity index NK cell CD56,T cells subsets CD3,CD4,CD8and CD4/CD8between two groups (P>0.05). Two kinds of serum tumormarkers including CEA and SCC-Ag were no significant differences betweentwo groups for esophageal cancer patients(P>0.05)；Four kinds of serum tumormarkers including CEA,CA50,CA199and CA72-4were no significantdifferences between two groups for cardia adenocarcinoma patients(P>0.05)；Four kinds of serum tumor markers including CEA,CYFRA21-1,NSE andSCC-Ag were no significant differences between the groups for lung cancerpatients (P>0.05). The accidence rate of operative complications were nosignificant differences between two groups was found for esophageal cancer,cardia adenocarcinoma and lung cancer patients (P>0.05). No significantdifferences of recurrence rate, transfer rate and survival rate were detectedbetween two groups(P>0.05).Conclusion: The application of fluorouracil implants in thoracic tumorpatients is a safe,effective and convenient therapeutic method,which bringsnegligible influence to immune functions of patient,and does not increase anyadditional operation risk and complication. The effectiveness of improvedpatient survival rate,reduce postoperative recurrence rate needs further study.