摘要
目的:观察结直肠癌肝转移患者中应用新辅助化疗的临床效果及安全性。方法:选取2013年7月-2015年7月期间于苏州永鼎医院肿瘤科收治的结直肠癌肝转移患者40例,采用单纯FOLFIRI方案者3例,FOLFOX6方案者27例,两种方案联合应用10例。获得手术条件后停止化疗至少15 d后方可进行手术治疗,开腹或腹腔镜下切除原发灶,开腹手术切除肝转移灶。结果:新辅助化疗对转移灶有效率67.5%(27/40),对原发灶有效率55.0%(22/40)。治疗前血清CEA阳性率85.0%(34/40),接受新辅助化疗后血清CEA阳性率为47.5%(19/40),新辅助化疗前后血清CEA阳性率比较差异有统计学意义(字2=5.774,P<0.05),同时血清CEA值比较差异有统计学意义(t=15.745,P<0.05)。新辅助化疗前原发灶平均大小(2.16±0.51)cm,化疗后平均大小(1.30±0.44)cm,化疗前后比较差异有统计学意义(t=4.084,P<0.05)。新辅助化疗前转移灶平均大小(7.64±2.18)cm,化疗后平均大小(3.97±1.15)cm,化疗前后比较差异有统计学意义(t=9.004,P<0.05)。14例(35.0%)患者获得根治性切除术,其中1例患者发生切口感染,1例患者发生肝功能衰竭,并发症发生率为5.0%,无患者发生围手术期死亡。结论:随着肝脏外科手术技术的进一步发展以及新辅助化疗方面研究的进一步深入,新辅助化疗在改善结直肠癌肝转移患者预后中扮演越来越重要的角色。
Objective：To observe the effect and safety of neo-adjuvant chemotherapy applied in colorectal cancer with hepatic metastasis treatment.Method：40 patients with colorectal cancer and hepatic metastasis were selected in department of oncology of Yongding hospital of Suzhou from July 2013 to July 2015. 3 cases were given FOLFIRI plan,27 cases were given FOLFOX6 plan and 10 cases were given both plans.Surgical treatment was given chemotherapy stopped after 15 days when operation conditions were obtained. Primary tumor was removed with open operation or laparoscopic surgery and metastatic liver cancer was removed by open operation.Result：The efficient of neo-adjuvant chemotherapy on metastatic lesions was 67.5%（27/40） and primary tumor was 55.0%（22/40）. The positive rate of CEA in serum was 85.0%（34/40）,while after neo-adjuvant chemotherapy it was 47.5%（19/40）,there was statistical difference of positive rate of CEA in serum before and after neo-adjuvant chemotherapy（ 字2=5.774,P〈0.05）,and the difference was statistically significant in serum CEA value between before and after neo-adjuvant chemotherapy（t=15.745,P〈0.05）.The average size of primary tumor before neo-adjuvant chemotherapy was（2.16±0.51）cm,after neo-adjuvant chemotherapy it was（1.30±0.44）cm,there was statistical difference of primary tumor size（t=4.084,P〈0.05）.The average size of metastatic lesions before neo-adjuvant chemotherapy was（7.64±2.18）cm, after neo-adjuvant chemotherapy it was（3.97±1.15）cm,there was statistical differences of metastatic lesions size（t=9.004,P〈0.05）.There were 14 patients（ 35.0%） given radical resection,1 case of incision infection and 1 case of liver failure,the incidence of complication was 5.0%,there was no perioperative death.Conclusion：With liver surgery improved and study of neo-adjuvant chemotherapy deeper, it is more important of neo-adjuvant chemotherapy for prognosis of colorectal cancer with hepatic metastasis patients.
出处
《中国医学创新》
CAS
2015年第30期137-140,共4页
Medical Innovation of China
关键词
新辅助化疗
结直肠癌
肝转移癌
预后
生存率
Neo-adjuvant chemotherapy
Colorectal cancer
Metastatic liver cancer
Prognosis
Survival rate
