Clinical Research Of Intraperitoneal Chemotherapy With5-FU Sustained Release For Implant In Colorectal Cancer

Objective:To investigate the safety of intraperitoneal implantation of5-FU sustained release agent into the patients with colorectal cancer in the Dukes B and C periods and its clinical efficacy.Methods:The rectal cancer patients in Gastrointestinal Surgery department of Xiangya Hospital from January2008to December2009, according to the inclusion and exclusion criteria, have been selected and finally screened161cases divided into a treatment group (81cases), which were implanted600mg of5-FU slow-release agent in colorectal resection uniformly lesions the excision area as well as the vicinage of the superior mesenteric artery after500ml warm saline washed abdominal cavity and pelvic cavity. And the control group of80cases,are flushed with500ml saline in the abdominal and pelvic colorectal resection. According to the NCCN guidelines, the two groups of patients accepted systemic chemotherapy which is FOLFOX4program in4weeks after surgery. Those patients after wound healing, are observed with or without chemical peritonitis, anastomotic leakage, wound infection, incomplete intestinal obstruction, blood, liver and kidney function changes. We observe the incidence rates of side effects including the liver and kidney function, bone marrow suppression reaction and the digestive reaction of the intraperitoneal chemotherapy after surgery. The metastasis rates of the organs in the abdominal and pelvic cavity, local recurrence, lung,3years disease-free survival rates and3year overall survival rates are compared between the two groups through the regular follow-up review.Results:The general information (age, sex, degree of differentiation and surgical approach) are of no significant difference (P>0.05). There are no statistically significant difference in the preoperative hematopoietic function, liver function and kidney function between the groups(P>0.05). The operative time, amount of bleeding and blood transfusion during the operation of the patients shows no significant difference (P>0.05). The recovery of the function of the hematopoietic system, liver, kidney, gastrointestinal system are of no significant difference in postoperative(P>0.05). There is no statistically significance of the liver and kidney funcyion, bone marrow suppression reaction and digestive reaction in treatment group compared with the control group(P>0.05). The3years disease-free survival of the treatment group is76.5%, while the experimental group is57.5%, and the difference between those two groups is statistically significant different P<0.05). The3years overall survival rate of the two groups are82.4%and76.2%, which shows no significant difference.(P>0.05).Conclusions:The patients of Dukes B、C colorectal cancer who accepted intraperitoneal implantation of5-FU sustained release agent during the surgery have good tolerability,and the adverse reactions and side effects are slight. The way of intraperitoneal implantation of5-FU sustained release agent during the surgery can improve the3years disease-free survival, while the3years overall survival is of no significant difference.