术前FOLFOX6时辰化疗同期调强放疗在局部进展期直肠癌中的临床观察

Clinical observation of preoperative FOLFOX6 chrono-chemotherapy combined with intensity-modulated radiotherapy in locally advanced rectal cancer

目的探讨术前FOLFOX6时辰化疗同期调强放疗在局部进展期直肠癌中的应用价值。方法选取2016年10月至2019年8月廉江市人民医院收治的70例局部进展期直肠癌患者,随机分为观察组和对照组,每组各35例。对照组采用术前FOLFOX6常规化疗同期调强放疗,而观察组采用术前FOLFOX6时辰化疗同期调强放疗。对比两组的肿瘤分期、不良反应、细胞免疫指标和生活质量。结果与对照组相比,观察组的Ⅲ度神经毒性、总神经毒性、Ⅰ~Ⅱ度消化道反应、总消化道反应、Ⅰ~Ⅱ度贫血和总贫血的发生率均明显低(P<0.05)。术前放化疗对观察组生活质量的影响明显轻于对照组(P<0.05)。结论采用术前FOLFOX6时辰化疗同期调强放疗治疗局部进展期直肠癌患者可减轻放化疗不良反应和对患者生活质量的影响,同时可改善细胞免疫功能。

Objective To explore the application value of preoperative FOLFOX6 chrono-chemotherapy and intensity-modulated radiotherapy(IMRT)in locally advanced rectal cancer(LARC).Methods A total of 70 patients with LARC admitted to Lianjiang People’s Hospital from October 2016 to August 2019 were randomly from divided into the observation group and the control group,with 35 cases in each group.The control group received preoperative FOLFOX6 conventional chemotherapy and IMRT,while the observation group received preoperative FOLFOX6 chrono-chemotherapy and IMRT.The tumor stage,adverse reactions,cellular immune indexes and quality of life were compared between the two groups.Results Compared with the control group,the incidence of gradeⅢneurotoxicity,total neurotoxicity,gradeⅠ-Ⅱdigestive tract reaction,gradeⅠ-Ⅱanemia and total anemia in the observation group were significantly lower(P<0.05).The effect of preoperative radiotherapy and chemotherapy on the quality of life in the observation group was significantly less than that in the control group(P<0.05).Conclusion For patients with LARC,the preoperative FOLFOX6 chrono-chemotherapy combined with IMRT can reduce the adverse reactions of radiotherapy and chemotherapy and the impact on patients’quality of life,and improve cellular immune function.