摘要
目的直肠癌是我国常见的消化道恶性肿瘤,25%的直肠癌患者就诊时已属中晚期,有研究表明,新辅助化疗可降低肿瘤分期,提高患者的术后生存率。本研究评估低位直肠癌患者术前行XELOX方案(奥沙利铂+卡培他滨)治疗的有效性、安全性和患者的预后。方法收集2010-02-01-2011-10-31梁山县人民医院普外科(18例)和山东大学附属山东省肿瘤医院胃肠外科(31例)临床分期Ⅱ/Ⅲ期的低位直肠癌患者作为研究对象,随机分为新辅助化疗组(26例)和对照组(23例),新辅助化疗组术前接受3个周期的XELOX化疗后行手术治疗,对照组直接予以手术治疗。分析手术治疗的根治性切除率、化疗疗效、不良反应、术后并发症发生率和患者生存率。结果新辅助化疗组患者化疗有效率为80.8%(21/26),临床3~4级不良事件发生率为23.1%(6/26),手术R0切除率为92.3%,对照组手术R0切除率为69.6%,差异均有统计学意义,P<0.05。两组患者均未发生术后吻合口瘘和肠梗阻等严重并发症。新辅助化疗组术后3、5年总生存率分别为92.3%和80.8%,对照组分别为65.2%和52.1%,差异均有统计学意义,P<0.05。结论 XELOX新辅助化疗治疗低位直肠癌是可行和安全的,能够提高患者的临床受益、改善患者的生存率。
OBJECTIVE Rectal cancer is a common gastrointestinal malignancy in China,25% colorectal cancer pa- tients are in the middle and late stages, studies have shown that neoadjuvant chemotherapy can reduce tumor staging and improve postoperative survival. The objective of this study was to assess the efficacy,safety and survival rates of neoadju- vant chemotherapy use oxaliplatin combined with capecitabine（XELOX regimen） in patients with lower rectal cancer. METHODS Clinical stage Ⅱ/Ⅲ lower rectal cancer patients of Liangshan People＇s Hospital eighteen patients and Shan- dong Cancer Hospital Affiliated to Shandong University thirty-one patients from February 2010 to October 2011 were ran- domly divided into neoadjuvant chemotherapy group （26 cases） and control group （23 cases）. Patients in the neoadjuvant chemotherapy group was treated with three cycles XELOX followed by radical surgery. Patients in the control group was treated directly with surgery. The R0 resection rate, chemotherapy efficacy, adverse reaction, postoperative complication rate and postoperative survival rate were analyzed. RESULTS In the 26 patients receiving neoadjuvant chemotherapy, grade 3--4 adverse events occurred in 6 patients （23.1 ~）. The effectiveness of chemotherapy in neoadjuvant chemothera- py was 80.8%（21/26）,and the R0 cutting rate was 92.3%0. The R0 cut rate of the control group was 69.6%, and the difference was statistically significant （P〈0. 05）. There was no significant difference in the incidence of postoperative complications between the two groups（P〉0.05）. The Overall survival rate of the new adjuvant chemotherapy group was 92.3% and 80.8% respectively was higher than that of the control group which was 65.2% and 52.1% in 3 and 5 years, and the difference was statistically significant （P〈0.05）. CONCLUSION This pilot study showed that neoadjuvant XE- LOX for lower rectal cancer is feasible and safty, which can improve the patient＇s clinical benefit and improve the survival rate of pat
出处
《中华肿瘤防治杂志》
CAS
北大核心
2017年第15期1091-1093,共3页
Chinese Journal of Cancer Prevention and Treatment
基金
山东省医学科学院院级青年基金(2015-75)
山东省医药卫生科技发展计划(2016WS0551)
