XELOX新辅助化疗治疗局部进展期低位直肠癌初步研究

发布时间：2018-12-12 12:48

【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,P0.05。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,P0.05。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。
[Abstract]:Objective rectal cancer is a common malignant tumor of digestive tract in China. 25% of patients with rectal cancer are in the middle and advanced stage. Some studies have shown that neoadjuvant chemotherapy can reduce tumor stage and improve postoperative survival rate. The purpose of this study was to evaluate the efficacy, safety and prognosis of XELOX regimen (oxaliplatin capecitabine) before operation in patients with low rectal cancer. Methods 18 cases of general surgery in Liangshan County people's Hospital from 2010-02-01-2011-10-31 and 31 cases of Gastrointestinal surgery in Shandong Cancer Hospital affiliated to Shandong University were collected as subjects. The neoadjuvant chemotherapy group (n = 26) and the control group (n = 23) were randomly divided into two groups. The neo-adjuvant chemotherapy group received three cycles of XELOX chemotherapy before operation and the control group received direct surgical treatment. The rate of radical resection, the curative effect of chemotherapy, the adverse reaction, the incidence of postoperative complications and the survival rate of the patients were analyzed. Results in the neoadjuvant chemotherapy group, the effective rate of chemotherapy was 80.8% (21 / 26), the incidence of adverse events in grade 3 was 23.1% (6 / 26), the rate of R0 resection was 92.3%, and that of the control group was 69.6%. The difference was statistically significant (P 0.05). There were no serious complications such as anastomotic fistula and intestinal obstruction in both groups. The 3- and 5-year overall survival rates of neoadjuvant chemotherapy group were 92.3% and 80.8%, respectively, while those of control group were 65.2% and 52.1, respectively. The difference was statistically significant (P0.05). Conclusion XELOX neoadjuvant chemotherapy is feasible and safe in the treatment of low rectal cancer.
【作者单位】：梁山县人民医院普外科;山东大学附属山东省肿瘤医院胃肠外科山东省医学科学院;
【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)
【分类号】：R735.37

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