摘要
目的探讨奥沙利铂联合卡培他滨在低位进展期直肠癌患者术前新辅助治疗中的应用价值。方法纳入2013年3月至2014年3月本院90例局部进展期低位直肠癌患者作为研究对象,随机抽签分为两组,每组各45例。观察组术前给予奥沙利铂+卡培他滨化疗联合静态调强放疗(IMRT),对照组行卡培他滨化疗联合IMRT,治疗结束后两组均接受腹腔镜直肠癌根治术。比较两组治疗效果,观察放、化疗不良反应和术后并发症发生率。结果经术前新辅助放化疗后,观察组R0切除41例(91.11%),对照组R0切除32例(71.11%),两组R0切除率差异有统计学意义(P <0.05)。观察组新辅助治疗有效率高于对照组,差异有统计学意义(P <0.05)。两组白细胞降低、血小板减少、胃肠道反应、神经毒性及中性粒细胞减少等毒副反应差异均无统计学意义(均P> 0.05)。两组放疗不良反应发生率比较,差异无统计学意义(P> 0.05)。两组术后并发症总发生率差异无统计学意义(P> 0.05)。观察组术后3年无进展生存34例,总生存37例;对照组无进展生存25例,总生存32例。两组无进展生存率差异有统计学意义(Log-rank X^2=4.128,P=0.042),两组总生存率差异无统计学意义(Log-rank X^2=1.703,P=0.192)。结论将奥沙利铂联合卡培他滨用于局部进展期低位直肠癌患者术前新辅助治疗中可获得较好的手术切除效果,有助于延长术后无进展生存时间,较单用卡培他滨使患者获益更多。
Objective To investigate the effect of oxaliplatin combined with capecitabine as preoperative neoadjuvant treatment in patients with advanced low rectal cancer. Methods 90 patients who were treated in our hospital between March 2013 and March 2014 were recruited as study subjects and were randomly assigned to two groups, with 45 patients in each group. Patients in the treatment group received oxaliplatin combined with capecitabines in conjunction with intensity modulated radiation therapy （IMRT） before operation. Patients in the control group received capecitabines in conjunction with IMRT. After treatment, both groups received laparoscopic radical resection of rectal cancer. Treatment effectiveness was compared between the two groups. Adverse events related to radio- and chemotherapy and incidence of postoperative complications were recorded. Results After preoperative neoadjuvant, there were 41 patients with R0 resection in the treatment group （91.11%） and 32 in the control group （71.11%）, with significant betweengroup difference （P 〈 0.05）. Treatment effectiveness rate was significantly higher in the treatment group than in the control group （P 〈 0.05）. Adverse events such as leukocytopenia, thrombocytopenia, gastrointestinal reaction, neurotoxicity and neutropenia were similar between the two groups （P 〉 0.05）. Incidence of adverse event related to radiotherapy and total incidence of postoperative complications were similar between the two groups （P 〉 0.05）. After three years of follow-up, 34 patients in the treatment group were progression-free and 37 survived. The corresponding figures were 25 and 32, respectively in the control group. There was significant difference in progression-free survival （Log-rank χ^2 = 4.128,P = 0.042）, but overall survival was similar between the two groups （Log-rank χ^2 = 1.703 ,P = 0.192）. Conclusion Oxaliplatin combined with capecitabine as preoperative neoadjuvant therapy can achieve favorable outcome in resection in treating pati
作者
李军
吴文凯
Li Jun;Wu Wenkai(Department of Oncology,Radiotherapy Room;Department of Anorectal Diseases,Guangyuan Central Hospital,Guangyuan,Sichuan,628000,China)
出处
《结直肠肛门外科》
2018年第5期459-463,共5页
Journal of Colorectal & Anal Surgery
基金
广元市医药卫生科技项目(编号:2016A010092)
