新辅助化疗联合腹腔镜手术对直肠癌的疗效分析

Efficacy of Neoadjuvant Chemotherapy Combined with Laparoscopic Operation in the Treatment of Colorectal Cancer

目的探讨新辅助化疗联合腹腔镜手术治疗直肠癌的临床疗效。方法选取直肠癌患者104例,随机分为观察组和对照组各52例。两组患者均给予腹腔镜直肠癌切除术治疗,观察组在术前采用FOLFOX4化疗方案给予4个周期的化疗,术后继续行8个周期的化疗。对照组则在术后给予12个周期的化疗。对比两组患者手术前后癌胚抗原(CEA)和糖类抗原199(CA199)的变化情况、手术时间、术中出血量、术后肛门首次排气时间、术后住院天数以及术后并发症的发生情况。结果两组患者的手术时间、术中出血量、术后肛门首次排气时间和术后首次下床活动时间比较,差异均无统计学意义(P>0.05);观察组术后并发症发生率为7.69%,对照组为9.62%,两组比较,差异无统计学意义(P>0.05);观察组术后3个月CEA转阴率为69.44%,CA199的转阴率为68.00%,均显著高于对照组(P<0.05);观察组术后无疾病进展生存期为(11.31±1.03)个月,中位生存期为(32.04±2.13)个月,均显著长于对照组(P<0.05)。结论新辅助化疗联合腹腔镜手术有助于提高直肠癌的临床疗效,改善患者的预后,且不增加手术风险,安全性好。

Objective To investigate the clinical efficacy of neoadjuvant chemotherapy combined with laparoscopic operation in the treatment of colorectal cancer. Methods 104 patients with colorectal cancer were randomly divided into the observation group and the control group,each with 52 cases. Both groups were given laparoscopic resection for colorectal cancer,the observation group received 4 cycles of FOLFOX4 chemotherapy before operation,and 8 cycles of chemotherapy after operation. The control group received 12 cycles of chemotherapy after operation. Carcinoembryonic antigen( CEA) and carbohydrate antigen 199( CA199) changes,operation time,intraoperative bleeding volume,postoperative anal exhaust time,postoperative hospital stay and postoperative complications of the 2 groups before and after operation were compared. Results There had no statistically significant differences between the 2 groups in operation time,intraoperative bleeding volume,postoperative anal exhaust time and postoperative first ambulation time( P > 0. 05); postoperative complications rates in the observation group and the control group were7. 69% and 9. 62%,the difference was not statistically significant( P > 0. 05); 3 months after operation,CEA and CA199 negative rates in the observation group were 69. 44% and 68. 00%,which were significantly higher than those of the control group( all P <0. 05); in the observation group,progression-free survival was( 11. 31 ± 1. 03) months,median survival time was( 32. 04 ± 2. 13)months,which were significantly longer than those of the control group( P < 0. 05). Conclusion Neoadjuvant chemotherapy combined with laparoscopic operation can improve the clinical efficacy of colorectal cancer,improve the prognosis of the patients without increase the risk of operation,and it has good safety.