放疗联合卡培他滨治疗老年人直肠癌的临床疗效观察

Observation of efficacy of radiotherapy combined with xeloda monotherapy in the treatment of elderly patients with rectal cancer

目的 探讨放疗联合卡培他滨单药化疗在老年直肠癌患者治疗中的临床价值.方法 回顾性分析老年直肠癌患者80例的临床资料,根据患者采用的治疗方法将患者分为研究组（43例）和对照组（37例）.研究组采用放疗联合卡培他滨治疗,对照组仅单纯放疗.观察两组患者临床预后（3年存活率、复发率、无进展生存期）、术后健康相关的生存质量和主要并发症.结果 与对照组比较,研究组3年复发率显著降低（25.58%比48.65%,χ^2=4.579,P=0.032）,无进展生存期显著延长[（42.58±7.63）个月比（34.95±6.30）个月,t=7.495,P=0.000],术后1年健康相关的生存质量显著提高[（75.50±8.11）分比（69.76±9.58）分,t=3.295,P=0.002].两组患者术后主要并发症（粒细胞减少、腹泻、恶心、呕吐、手足综合征和感觉神经病变）和3年存活率比较差异均无统计学意义（均P〉0.05）.结论 放疗联合卡培他滨单药化疗有助于改善老年直肠癌患者无进展生存期和术后复发率.

Objective To investigate the clinical value of radiotherapy combined with xeloda monotherapy in the treatment of elderly patients with rectal cancer.Methods 80 elderly patients with rectal cancer were retrospectively collected.The patients were assigned into study group （n=43） or control group （n=37） according to the treatment way.The study group adopted radiotherapy combined with xeloda,while the control group only treated with radiotherapy.The main indicators included major clinical outcomes （3-year survival rate,recurrence rate,progression free survival）,and postoperative health related quality of life and major complications of the two groups were observed.Results Compared with the control group,the 3-year recurrence rate of the study group decreased significantly （25.58% vs.48.65%,χ^2=4.579,P=0.032）;the progression free survival was significantly prolonged [（42.58±7.63）months vs.（34.95±6.30）months,t=7.495,P=0.000];the quality of health related life after 1 year increased significantly [（75.50±8.11） vs.（69.76±9.58）,t=3.295,P=0.002].There were no significant differences in postoperative major complications （granulocyte reduction,diarrhea,nausea,vomiting,hand foot syndrome and sensory neuropathy） and 3-year survival rate between the two groups （all P〉0.05）.ConclusionRadiotherapy combined with xeloda chemotherapy helps improve progression free survival and recurrence rate in elderly patients with rectal cancer.