奥沙利铂联合5-Fu/LV的新辅助化疗在中低位直肠癌中的应用

Neoadjuvant Chemotherapy of Oxaliplatin and Fluorouracil/Leucovorin in Low Rectal Carcinoma

目的:探讨奥沙利铂联合5-Fu/LV的新辅助化疗在中低位直肠癌中的疗效。方法:2003~2005年收治的57例估计可切除的中低位直肠癌患者,分为实验组(23例)和对照组(34例),实验组于术前1周行奥沙利铂联合5-Fu/LV的方案化疗1疗程,奥沙利铂,130mg/m2(体表面积),2h静脉滴注,第一天用;亚叶酸钙,200mg/m2,2h静脉滴注,连用5d;5-Fu,300mg/m2,4~6h静脉泵入,连用5d。对照组不作任何放化疗。结果:实验组78·26%(18/23)的患者肿瘤体积缩小,变软。实验组手术根治率、保肛率显著高于对照组(P<0·05),淋巴结转移率则显著低于对照组(P<0·05)。结论:术前奥沙利铂联合5-Fu/LV的新辅助化疗可显著提高中低位直肠癌的根治率和保肛率,降低淋巴结转移率。

Objective: To evaluate the effects of preoperative chemotherapy in combination with oxaliplatin(L-OHP) and fluorouracil(5-Fu)/leucovorin(LV) in low rectal carcinoma. Methods: Fifty-seven patients with potentially respectable low rectal cancer were divided into experimental group or control group. In experimental group, oxaliplatin was administered at a dose of 130 mg/m^2 in 2-hour infusion on day 1; Leucovorin 200 mg/m^2 in 2-hour infusion followed by fluorouracil 300 mg/m^2 in 4-6 hours infusion on days 1-5. In control group, neither chemotherapy nor radiotherapy was given. Results: 78.26% (18/23) of patients in experimental group showed a decrease in tumor volume. Radical operation rate and preservation rate of the anal sphincter was higher in experimental group than in control group(P<0.05). A lower lymph node metastasis rate was noted in experimental group(P<0.05). Conclusion: Neoadjuvant chemotherapy in combination with oxaliplatin(L-OHP) and fluorouracil (5-Fu) /leucovorin(LV) can improve radical operation rate and preservation rate of the anal sphincter, and decreased lymph node metastasis rate in low rectal carcinoma.