结直肠癌术后早期应用FOLFOX方案辅助化疗的临床分析

Clinical analysis of FOLFOX regimen early application as adjuvant chemotherapy for colorectal cancer after operation

目的探讨结直肠癌术后早期应用奥沙利铂联合5-Fu／甲酰四氢叶酸辅助化疗的安全性和有效性。方法将80例行根治术后的Ⅱ、Ⅲ期结直肠癌患者随机分为两组（早期化疗组和对照组，各40例），早期化疗组与对照组分别于术后第1天和术后1个月开始辅助化疗，应用奥沙利铂联合5-F/甲酰四氢叶酸（FOLFOX方案），观察两组术后并发症、术后肠道功能恢复时间、切口愈合状况和化疗不良反应发生情况。结果两组手术及辅助化疗期间无死亡病例，无术后大出血、吻合口瘘等严重并发症。两组切口平均拆线时间：早期化疗组（9．6±2．2）d，对照组（9．3±2．8）d，两组比较差异无统计学意义（P〉0．05）。切口愈合状况差异无统计学意义。术后胃肠道功能恢复时间：早期化疗组（65v10）h，对照组（68±10）h，两组之间差异无统计学意义（P〉0.05）。术后1个月内两组各时间点对应白细胞减少比较差异无统计学意义（P〉0．05）。完成全疗程化疗后，两组不良反应发生情况基本相同。结论结直肠癌术后早期应用奥沙利铂联合5-Fu／甲酰四氢叶酸（FOLFOX方案）辅助化疗，不会影响患者切口愈合能力和增加术后并发症，对患者的功能恢复影响不大，对延长结直肠癌患者的生存期，减少术后复发可能会起到积极的作用。

Objective To investigate the safety and efficacy of early application of oxaliplatin combined with 5 - Fu/leucovorin as adjuvant chemotherapy for colorectal cancer after operation. Methods Eighty cases with stage Ⅱ,Ⅲ colorectal cancer were randomized into two groups ：early chemotherapy group and control group. The early chemotherapy group received adjuvant chemotherapy of oxaliplatin combined with 5 -Fu/leucovorin on the first postoperative day; While the control group received adjuvant chemotherapy after a month. Postoperative complications, gastrointestinalfunction recovering time, wound healing and side effect of chemotherapy in the two groups were reviewed. Results No death case was related to colorectomy and ajurant chemotherapy. There was no postoperative bleeding and anastomotic leakage. Stitches were took out of the wound at （9.6±2.2） days （early chemotherapy group） and （9.3 ±2.8） days （control group）（ P 〉 0. 05）. The healing condition of wound and gastrointestinal function recovering time showed no significant difference between two groups （ P 〉0. 05）. The incidence of leucocytopenia showed no significant difference between two groups in a month of postoperative period （ P 〉 0. 05）. The incidence of the adverse events was similar both in the early chemotherapy groups and control groups after whole cycles. Conclusions Early application of adjuvant chemotherapy （FOLFOX regimen） for colorectal cancer has no influence on the patients, wound healing, function recovering and will not increase the incidence of complication after redical coloreetomy. It may positively improve long term survival and decrease the recurrence.