CAJ | 학술논문

　　目的：分析细胞减灭术（CRS）加术中腹腔热灌注化疗术（HIPEC）对结直肠癌腹膜转移癌的疗效及安全性。方法：课题设计为回顾性病例对照研究，收集结直肠癌腹膜转移癌（CRC PC）患者资料，按临床病理参数匹配原则，分为CRS组（CRS+术后全身化疗）29例，HIPEC组（CRS+HIPEC+术后全身化疗）33例。分析两组的总体生存期（OS）及严重不良事件（SAE）。结果：两组患者临床病理学特征均衡可比，术中PCI评分及器官/腹膜切除情况相似。两组中位随访时间分别为41.9个月（6.5～110.0个月）和32.0个月（10.5～95.9个月），OS分别为8.5个月（95%CI：4.9～12.1个月）和14.5个月（95%CI：11.9～17.1月）（P=0.007）。术后30天内CRS组3例发生SAE，HIPEC组9例（P=0.126）。多因素分析显示，HIPEC、CC 0～1分、术后化疗周期≥6个周期为改善生存的独立预后因素。结论：CRS+HIPEC可改善CRCPC患者生存期，SAE无显著增加，安全性可接受。
　　목적：분석세포감멸술（CRS）가술중복강열관주화료술（HIPEC）대결직장암복막전이암적료효급안전성。방법：과제설계위회고성병례대조연구，수집결직장암복막전이암（CRC PC）환자자료，안림상병리삼수필배원칙，분위CRS조（CRS+술후전신화료）29례，HIPEC조（CRS+HIPEC+술후전신화료）33례。분석량조적총체생존기（OS）급엄중불량사건（SAE）。결과：량조환자림상병이학특정균형가비，술중PCI평분급기관/복막절제정황상사。량조중위수방시간분별위41.9개월（6.5～110.0개월）화32.0개월（10.5～95.9개월），OS분별위8.5개월（95%CI：4.9～12.1개월）화14.5개월（95%CI：11.9～17.1월）（P=0.007）。술후30천내CRS조3례발생SAE，HIPEC조9례（P=0.126）。다인소분석현시，HIPEC、CC 0～1분、술후화료주기≥6개주기위개선생존적독립예후인소。결론：CRS+HIPEC가개선CRCPC환자생존기，SAE무현저증가，안전성가접수。
Objective:To evaluate the efficacy and safety of cytoreductive surgery (CRS) in conjunction with hyperthermic intra-peritoneal chemotherapy (HIPEC) for treating patients with peritoneal carcinomatosis (PC) from colorectal cancer (CRC). Methods:A total of 62 CRC patients with complication of PC were divided into the CRS group, namely, Group One (n=29, CRS and systemic adju-vant chemotherapy) and the CRS+HIPEC group, namely, Group Two (n=33, CRS+HIPEC). The primary end point of the study was overall survival (OS) and the secondary end point was serious adverse events (SAE). Results:Patients' clinicopathologic characteris-tics, peritoneal carcinomatosis index, and completeness of cytoreduction therapy were well balanced and comparable between the two groups. The median follow-up was 41.9 mo (6.5 mo to 110.0 mo) in Group One and 32.0 mo (10.5 mo to 95.9 mo) in Group Two. The median OS was 8.5 mo (95%CI:4.9 mo to 12.1 mo) in Group One and 14.5 mo (95%CI:11.9 mo to 17.1 mo) in Group Two (P=0.007). Within 30 days after the surgery, SAE occurred in 3 of the 29 patients in Group One, and 9 of the 33 patients in Group Two (P=0.126). Multivariate analysis revealed that HIPEC, CC0-1 score, and chemotherapy over six cycles were the independent factors for OS improvement. Conclusion:The CRS+HIPEC method improves the OS of patients with PC from CRC, suggesting an acceptable safety.