直肠癌术后早期化疗疗效观察

Clinical evaluation of early postoperative adjuvant chemotherapy for rectal cancer

目的探讨结直肠癌术后早期化疗的安全性和有效性。方法将近年来收治的60例直肠癌根治术的患者随机分为两组,即早期化疗组与对照组,早期化疗组于术后48 h,对照组于术后1个月开始辅助化疗,两组均应用奥沙利铂联合氟脲嘧啶/甲酰四氢叶酸(FOLFOX方案),分别观察两组术后并发症、化疗不良反应,远处转移及3年生存率等。结果两组在化疗期间均无死亡病例,无明显术后或化疗后严重并发症。术后胃肠道功能恢复时间、术后1个月内两组各时间点对应白细胞减少、神经毒性、血小板减少等比较差异无统计学意义(P>0.05)。两种治疗方法疗效比较,早期化疗组、对照组局部复发、远处转移比较,差异均无统计学意义(P>0.05)。早期化疗组的3年生存率比对照组略高,但无统计学差异(P>0.05)。结论直肠癌术后早期应用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 adjuvant chemotherapy for colorectal cancer. Methods Sixty cases of rectal 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 （ FOLFOX regimen） on the first postoperative day. While the control group received adjuvant chemotherapy after a month. Postoperative complications, gastrointestinal function recovery time, wound healing and side effect of chemo- therapy in the two groups were reviewed. Results No death occurred during adju,Jant chemotherapy and no serious complications related to surgery and adjuvant chemotherapy. There were no significant differences in gastrointestinal function recovery time, leucocytopenia, neurotoxicity and thrombocytopenia in a month of postoperative period between two groups （ P 〉 0.05）. In addition, there were no significant differences in local recurrence, distant metastasis, and 3 - years survival rate between two groups （ P 〉 0.05）. Conclusion Early application of FOLFOX regimen for rectal cancer has no influence on wound healing and the incidence of complications after surgery. It may improve long - term survival of the patients with colorectal cancer and decrease the recurrence.