The Clinical Efficacy And Safety Evaluation Of Brucea Javanica Oil Emulsion Combined With HIPEC And Systemic Intravenous Chemotherapy In The Treatment Of Peritoneal Carcinomatosis From Colorectal Cancer

Objective:To study the clinical efficacy and safety of Brucea javanica oil emulsion combined with HIPEC and systemic intravenous chemotherapy in the treatment of peritoneal carcinomatosis from colorectal cancer.Methods:A total of 108 CRC PCwho had achieved satisfactory reduction after cytoreductive surgery(RD<1cm)were randomlydivided into three groups:i.e.Group A,Group B and Group C,Each group has36 cases.The basic treatment are available for Group A(mFOLFOX6 intravenous chemotherapy scheme);The basic treatment and taking HIPEC three times within 48 hours after cytoreductive surgery are available for Group B;Group C was treated with intraperitoneal infusion of Brucea javanica oil emulsion and intravenous drip on the basis of group B.After 6 cycles of intravenous chemotherapy,the survival period,survival rate,postoperative complications,toxicity and side effects of chemotherapy,KPS score,level of tumor markers,level of T lymphocyte subsets in blood were compared among the three groups.Results:?There was no significant difference in the incidence of postoperative complications among the three groups(P>0.05).?There was no significant difference in the incidence of toxic and side effects between the three groups(P>0.05).Compared with the grading of toxic and side effects of chemotherapy,the degree of gastrointestinal symptoms in group C was more serious than that in group A and B(P<0.05),and the other toxic and side effects in the two groups were similar(P>0.05).?After HIPEC treatment,the KPS score in group B and C was significantly higher than that before treatment(P<0.05).Andafter intravenous chemotherapy,the KPS scores of the three groups increased in varying degrees(P<0.05).The KPS scores of group C were significantly higher than those of group A and B(P<0.05).?After treatment,the levels of CD3+,CD4+,CD4+/CD8 increased and the levels of CD8+ decreased in the three groups,but there was no significant difference between groups A and B,but there was significant difference between groups C(P<0.05).The levels of CD4+/CD8+in group C were significantly higher than those in group A and B after HIPEC treatment,and the levels of CD8+ were significantly lower,while the levels of CD3+,CD4+,CD4+/CD8 were significantly higher than those in group A and B after HIPEC treatment.The difference was significant(P<0.05).?The levels of CEA,CA199,CA242 and CA125 in group C decreased significantly after chemotherapy compared with those in group A and B(P<0.05);?The median survival time and progression-free survival time in group C were significantly longer than those in group A and group B(P<0.05).The 1,2and3-year survival rates was significantly higher than that of group A and B,and the difference was significant(P<0.05).Conclusion:Brucea javanica oil emulsion+HIPEC combined with systemic intravenous chemotherapy in the treatment of peritoneal metastasis of colorectal cancer can significantly prolong the survival time,improve survival rate,reduce the concentration of tumor markers in peripheral blood,improve immunity of patients,but the incidence and severity of complications and toxic side effects of chemotherapy have not increased significantly.It is safe and effective,and worthy of clinical application.