不同新辅助化疗方案治疗结肠癌临床对照观察研究

Clinical Study of Colon Cancer Treated with Different Neoadjuvant Chemotherapy Regimens

目的:观察两种不同新辅助化疗方案联合手术治疗结肠癌的疗效。方法:收集结肠癌患者42例,根据随机数字表分配分为治疗组(23例)和对照组(19例)。治疗组术前静脉滴注奥沙利铂联合替吉奥口服,术后2周开始追加4个周期的化疗。对照组术前静脉滴注奥沙利铂联合5-氟尿嘧啶及甲酰四氢叶酸口服,术后2周开始追加4个周期的化疗。随访3年,从不良反应、化疗前后瘤体直径变化、手术时间、术中出血量、实体肿瘤疗效评价标准RECIST等方面进行疗效评价。结果:化疗前治疗组肿瘤直径20~32mm(25.87±3.37)mm,对照组19~34mm(26.58±3.83)mm。化疗后治疗组肿瘤直径15~22mm(17.22±2.41)mm,对照组18~30mm(23.00±3.26)mm,两组经化疗前后瘤体缩小程度组内及组间对比均存在统计学差异(P<0.001)。两组手术时间、术中出血量无差异。结论:新辅助化疗对于缩小结肠癌瘤体有效,可认为奥沙利铂联合替吉奥用于新辅助化疗在减少骨髓抑制、消化道反应发生率及降期效果上优于奥沙利铂联合FL。

Objective To observe the effect of two different neoadjuvant chemotherapy regimens combined with surgery in treatment of colon cancer.Methods Totally 42 patients with colon cancer were randomly divided into treatment group(23 cases)and control group(19 cases).Patients in the treatment group received intravenous infusion of oxaliplatin combined with tegafur before operation and received 4 cycles of chemotherapy 2 weeks after operation.The patients in control group received oral administration of oxaliplatin combined with 5-fluorouracil and leucovorin before operation and received 4 cycles of chemotherapy 2 weeks after operation.Follow up for 3 years,from adverse reactions,changes of tumor diameter before and after chemotherapy,operation time,intraoperative bleeding volume,evaluation of curative effect of solid tumor.The efficacy of RECIST was evaluated.Results The diameter of tumor was(25.87±3.37)mm in the treatment group and(26.58±3.83)mm in the control group.The tumor diameter of the treatment group was(17.22±2.2)mm after chemotherapy and(23.00±3.26)mm in control group,with statistical difference between the two groups before and after chemotherapy(P<0.001).There was no difference in operative time and blood loss between the two groups.Conclusion Neoadjuvant chemotherapy is effective in reducing the tumor size of colon cancer.It can be concluded that oxaliplatin combined with tegafur is superior to oxaliplatin combined with FL in reducing bone marrow suppression and incidence of digestive tract reaction and decreasing phase.