FOLFOX_4方案新辅助化疗对老年局限性低位直肠癌的疗效

The Clinical Effects of Neoadjuvant Chemotherapy for Elderly Patients with Local Lower Rectal Cancer

目的观察FOLFOX4方案新辅助化疗对老年局限性低位直肠癌患者的临床疗效及安全性。方法选择我院收治的56例老年局限性低位直肠癌患者为研究对象,并将其随机分为观察组与对照组,各28例。观察组患者在术前进行FOLFOX4新辅助化疗,对照组不进行化疗直接进入手术治疗,观察和比较两组患者的肿瘤进展情况、手术保肛率、术后疗效及不良反应的发生情况。结果观察组进行新辅助化疗的总有效率为65.38%(17/26),化疗后肿瘤分期降低。观察组和对照组的保肛率分别为92.31%、64.29%,观察组显著高于对照组,差异具有统计学意义(P<0.05);观察组患者术后1、2、3年的生存率分别为92.31%、66.67%和44.44%,对照组分别为67.86%、57.89%和41.67%,两组比较差异均无统计学意义(P>0.05)。观察组化疗出现的副作用主要为恶心、呕吐、神经毒性及白细胞数量下降,其中2例因不耐受退出化疗。结论采用FOLFOX4方案新辅助化疗治疗老年局限性低位直肠癌可有效降低患者的肿瘤分期,提高手术保肛率。

Objective To observe the clinical efficency and safety of neoadjuvant chemotherapy with FOLFOX4 regime for elderly patients with local lower colorectal cancer. Methods A total of 56 elderly patients with local lower colorectal cancer admitted in our hospital were selected and randomly divided into the observation group and control group, 28 cases in each group. The observation group was treated with FOLFOX4 regime neoadjuvant chemotherapy before surgery, while the control group underwent directly surgical treatment without chemotherapy. Then the tumor progression were observed and compared between the two groups, and the sphincter preservation, short and long-term efficeny and the incidence of adverse reactions were analyzed. Results The total effective rate of neoadjuvant chemotherapy in observation group was 65.38%（17/26）, and the tumor stages decreased after chemotherapy. The sphincter preservation rates of observation group and control group were 92.31% and 64.29% respectively, which was significantly higher in the observation group（P0.05）. After operation, the 1-, 2-, 3-year survival rates were 92.31%, 66.67% and 44.44% respectively in the observation group, and were respectively 67.86%, 57.89% and 41.67% in the control group. No conspicuous difference was found between the two groups（P0.05）. The main adverse reactions in observation group included nausea, vomit, neurotoxicity and hemameba decline. Two cases in the observation group terminated chemotherapy because of intolerance. Conclusion The FOLFOX4 regime neoadjuvant chemotherapy could significantly reduce cancer stage and improve the sphincter preservation rate in the treatment of elderly patients with local lower colorectal cancer.