CAJ | 학술논문

目的：探讨肿瘤细胞减灭术（CRS）加腹腔热灌注化疗（HIPEC）治疗结直肠癌腹膜转移癌（ CRC PC）的疗效及安全性。方法选取结直肠癌腹膜转移癌（ CRC PC）患者67例，随机分为治疗组（ CRS＋HIPEC）38例，对照组（CRS＋静脉辅助化疗）29例，比较两组的生存期、生存率、术后并发症及化疗毒副作用。结果治疗组中位生存期23.0个月，显著长于对照组的11.0个月（ P＜0.01），治疗组1、2、3年生存率分别为70.9％、45.7％、8.2％，分别优于对照组的68.8％、21.2％、0％。术后并发症发生率两组相似（ P＞0.05）。化疗毒副作用：对照组恶心呕吐、白细胞减少、血小板减少发生率较治疗组高（P＜0.01），而治疗组腹胀、腹泻发生率较对照组高（ P＜0.01或P＜0.05）；两组其他毒副作用相似（ P＞0.05）。结论 CRS＋HIPEC治疗CRC PC能明显延长患者生存期，并发症和化疗毒副作用并没有明显增加。
목적：탐토종류세포감멸술（CRS）가복강열관주화료（HIPEC）치료결직장암복막전이암（ CRC PC）적료효급안전성。방법선취결직장암복막전이암（ CRC PC）환자67례，수궤분위치료조（ CRS＋HIPEC）38례，대조조（CRS＋정맥보조화료）29례，비교량조적생존기、생존솔、술후병발증급화료독부작용。결과치료조중위생존기23.0개월，현저장우대조조적11.0개월（ P＜0.01），치료조1、2、3년생존솔분별위70.9％、45.7％、8.2％，분별우우대조조적68.8％、21.2％、0％。술후병발증발생솔량조상사（ P＞0.05）。화료독부작용：대조조악심구토、백세포감소、혈소판감소발생솔교치료조고（P＜0.01），이치료조복창、복사발생솔교대조조고（ P＜0.01혹P＜0.05）；량조기타독부작용상사（ P＞0.05）。결론 CRS＋HIPEC치료CRC PC능명현연장환자생존기，병발증화화료독부작용병몰유명현증가。
Objective To evaluate the efficacy and safety of cytoreductive surgery (CRS) combined with hy-perthermic intraperitoneal chemotherapy ( HIPEC) in treating patients with peritoneal carcinomatosis ( PC) from color-ectal cancer(CRC).Methods A total of 67 CRC PC were divided into two group:therapeutics group(n=38, CRS+HIPEC) and control group(n=29, CRS and systemic adjuvant chemotherapy ).Overall median survival,survival rate, adverse reaction were compared .Results Therapeutic group had a significantly better overall median survival when compared to control group (23.0 months vs.11.0 months)(P<0.01).The 1-, 2-and 3-year survival rate of therapeutic group were 70.9%,45.7%and 8.2%, respectively, superior to those of control group (68.8%,21.2%and 0%) .Two group had a similar postoperative complication rate ( P>0.05 ) .Chemotherapy toxic effects:control group had higher incidence rate in nausea and vomiting , leucopenia , thrombocytopenia ( P<0.01 ) while therapeutic group higher in abdominal distension and diarrhea ( P<0.01 or P<0.05 ) .Two group had similar incidence rate in hypoproteinemia , hepatic and renal insufficiency , respiratory tract infections , hyperbilirubinemia ( P>0.05 ) .Con-clusion The CRS+HIPEC method can greatly improve the survival of patients with PC from CRC while doesn′t sig-nificantly increase postoperative complication rate and chemotherapy toxic effects .