XELOX方案同期化疗联合调强适形放疗治疗复发和局部晚期直肠癌的护理

Nursing of Recurrent and Advanced Rectal Cancer Patients Receiving Concurrent XELOX Chemotherapy and Intensity Modulated Conformal Radiotherapy

目的:探讨卡培他滨(Xeloda,希罗达)联合奥沙利铂(LOHP)(XELOX方案)同期化疗联合调强适形放疗治疗复发和局部晚期直肠癌的临床护理。方法:对32例复发和局部晚期直肠癌患者XELOX方案同期化疗联合调强适形放疗的临床资料进行回顾性分析,治疗前采取心理护理,治疗期间及治疗后采取相应的护理措施。结果:本组32例患者中CR 3例,PR 22例,总有效率为78.1%。主要不良反应为骨髓抑制、神经系统毒性、手足综合征、恶心呕吐、腹泻、放射性直肠炎及膀胱炎等,但均无Ⅲ度一Ⅳ度毒副反应发生。结论:XELOX.方案同期调强适形放疗治疗复发和局部晚期直肠癌配合有效的护理措施,能有效减轻放化疗的副反应,有利于患者的预后和康复,提高生存质量。

Objective： To discuss the nursing methods of recurrent and locally advanced rectal cancer patients receiving concurrent XELOX regimen（Xeloda plus LOHP） chemotherapy and intensity modulated conformal radiotherapy. Methods： Clinical records of 32 cases of recurrent and locally advanced rectal cancer accepting concurrent XELOX regimen chemotherapy and intensity modulated confonnal radiotherapy were analyzed. Nursing procedures including pre-therapy psychological nursing was used before therapy, and suitable nursing measures were used during and after treatment. Results： The overall effective rate was 78.1% with 3 cases got CR and 22 PR. The main side-effects included myelosuppression, neurotoxicity, hand-foot syndrome, nausea and vomiting, diarrhea, radiation proctitis, and cystitis. Conclusion： The concurrent XELOX regimen chemotherapy and intensity modulated conformal radiotherapy is proved effective in the treatment of recurrent and locally advanced rectal cancer. In order to accelerate the recovery of patients and improve their life qulities after chemoradiotherapy, appropriate nursing on the nutrition, skin, mouth, ostomy and psychological status of patients should be carried out to alleviate the side-effects.