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Radical resection for low rectal carcinoma combined with infusion pump chemotherapy via internal iliac artery

By Bo YANG, Yong-dong PU, Jian-miao HE, Bin LIU, Li-guo DONG, Zhi-yu CAO, Rong QIN, Wei-ping LIU, Yi WANG, You-jun WU and Gang LV

Abstract

Objective To evaluate the effects and practicability of radical resection for low rectal carcinoma with infusion pump chemotherapy via internal iliac artery,and explore the correlation factors influencing the therapeutic effects.Methods Data of 316 patients with low rectal carcinoma,admitted from Oct.1997 to Mar.2008,were retrospectively analyzed and assigned into 2 groups according to the treatment: Patients received infusion pump chemotherapy via internal iliac artery to target area combined with intravenous systemic chemotherapy were assigned into group A(n=249),and those receiving systemic chemotherapy alone following radical resection were assigned to group B(n=67).The timing of pump chemotherapy to target area in group A was set at day 12 after recovery of digestive function,with regimen of 5-FU at 0.5g per dose plus hydroxycamptothecin at 10-15mg per dose,twice a week,four times as a treatment course for a total of 6 courses,and it was followed by intravenously systemic chemotherapy with a regimen of FOLFIRI or FOLFOX.In group B,at day 12 right after recovery of digestive function,the intravenous sytemic chemotherapy was started with the same regimen as in group A.The local recurrence rate,metastasis rate and survival rate after 1,3 and 5 years in the two groups were respectively observed and compared,and the correlation between the clinicopathological features and the 5 year local recurrence rates and survival rates was analyzed in patients of group A.Results In group A,the local recurrence rate at year 1,3 and 5 was 0,1.68%(4/238) and 3.79%(8/211),respectively,the metastasis rate was 0.80%(2/249),4.62%(11/238) and 10.90%(23/211),respectively,and the survival rate was 100%,77.73%(185/238) and 72.04%(152/211),respectively.In group B,the local recurrence rate at year 1,3 and 5 was 0,9.52%(6/63) and 16.36%(9/55),respectively,the metastasis rate was 1.49%(1/67),15.87%(10/63) and 27.27%(15/55),respectively,and the survival rate was 100%(67/67),58.73%(37/63) and 52.73%(29/55),respectively.There was no significant difference between the two groups(P>0.05) for 1-year local recurrence rate,metastasis rate and survival rate.The 3-and 5-year local recurrence rates and metastasis rates were lower and the survival rate was higher in group A than in group B(P < 0.05).The degree of differentiation of the tumor and Duke’s stage of cancer may be the factors influencing the 5-year local recurrence rate,metastasis rate and survival rate.Conclusions The chemotherapy via internal iliac artery with an implanted pump following radical resection for low rectal carcinoma may give a satisfactory effect on the cure rate for low rectal cancer by lowering the 5-year local recurrence rate and metastasis rate and raising the survival rate.Degree of differentiation of the tumor and Duke’s stage may play an important role in therapeutic effectiveness-and survival of the patients

Topics: rectal neoplasms;chemotherapy,cancer,regional perfusion;colorectal surgery, Medicine (General), R5-920, Medicine, R, DOAJ:Medicine (General), DOAJ:Health Sciences
Publisher: Editorial Board of Medical Journal of Chinese People's Liberation Army
Year: 2011
OAI identifier: oai:doaj.org/article:0d5bca982e224178984fc1477dd5613c
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