结肠癌患者术后开始化疗时机对患者远期预后的影响

Effect of timing of postoperative chemotherapy on the long-term prognosis of patients with colon cancer

目的:探讨结肠癌患者术后开始化疗时机对患者远期预后的影响。方法:选择2011年2月至2013年6月我科室接受治疗的结肠癌患者105例,所有患者均采用手术治疗,根据术后化疗时机分为术后2周组(n=35例)、术后4周组(n=35例)和术后6周组(n=35例)。术后2周组在手术结束后2周开始化疗,术后4周组在手术结束后4周开始化疗,术后6周组在手术结束后6周开始化疗,化疗方案均选择FOLFOX4方案。3组化疗不同时间点采用酶联免疫吸附试验测定3组肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)及白细胞介素-10(IL-10)水平;对患者进行4～5年随访,记录3组治疗过程中毒副反应、远期生存期等指标,比较术后不同化疗时机对患者远期预后的影响。结果:术后4周组化疗后TNF-α、IL-6及IL-10水平,低于术后2周组与术后6周组(P <0. 05);术后2周组、术后4周组及术后6周组化疗10个疗程毒副反应发生率比较差异无统计学意义(P> 0. 05); 3组治疗后1年、3年及5年生存率,术后4周组高于术后2周组与术后6周组(P <0. 05)。结论:结肠癌患者术后第4周时开始化疗效果理想,有助于降低炎症因子水平,能改善患者预后,提高术后存活率。

Objective:To investigate the effect of postoperative chemotherapy on the long-term prognosis of patients with colon cancer.Methods:From February 2011 to June 2013,105 patients with colon cancer received treatment in our department.All patients were treated by operation.According to the time of postoperative chemotherapy,35 patients were divided into 2 weeks group(n=35),4 weeks group(n=35)and 6 weeks group(n=35).Chemotherapy started 2 weeks after operation in 2 weeks after operation group.Chemotherapy started 4 weeks after operation in 4 weeks after operation group.Chemotherapy started 6 weeks after operation in 6 weeks after operation group.All the chemotherapy regimens were selected for FOLFOX4 regimen.3 groups were treated with different time points of chemotherapy.Enzyme-linked immunosorbent assay(Elisa)was used to determine the level of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and interleukin-10(IL-10).Followed up for 4~5 years to record the side effects and long-term survival of the three groups,and to compare the influence of different chemotherapeutic opportunities on the long-term prognosis of the patients.Results:The levels of TNF-α,IL-6 and IL-10 in 4 weeks after operation group were lower than those in 2 weeks after operation group and 6 weeks after operation group(P<0.05).There was no significant difference in the incidence of side effects between 2 weeks after operation group,4 weeks after operation group and the 6 weeks after operation group(P >0.05).The 1-year,3-year and 5-year survival rates after treatment in the 3 groups were analyzed.The postoperative 4 weeks after operation group was higher than that of the 2 weeks after operation group and the 6 weeks after operation group(P<0.05).Conclusion:Colon cancer patients have the best effect of chemotherapy at the fourth week after operation,which can help to reduce the level of inflammatory factors,improve the prognosis of patients and improve the survival rate.