新辅助化疗与新辅助放化疗联合直肠癌手术的治疗效果比较

Comparison of the effects of neoadjuvant chemo- or chemoradiotherapy combined with surgery for locally advanced Rectal cancer patients

目的:通过多学科联合诊断,比较新辅助化疗(neoadjuvant chemotherapy, NCT)与新辅助放化疗(neoadjuvant chemoradiotherapy, NCRT)联合直肠癌手术的临床治疗效果。方法:回顾性分析2012年4月-2013年4月期间山西省肿瘤医院结直肠肛门外科收治确诊为局部晚期直肠癌(locally advanced rectal cancer, LARC)患者的临床资料。根据患者的治疗方案将患者分为NCRT组(新辅助放化疗+手术治疗)与NCT组(新辅助化疗+手术治疗),从多学科方向比较2组的治疗效果。研究用SPSS 22.0软件做数据分析。结果:NCRT组与NCT组在患者住院时间、手术时间及拔除尿管时间上的差异有统计学意义;两组在手术类型,病理完全缓解率(pathologic complete rate, pCR),术后拔除胃管及引流管的时间,术后排气、进食、活动的时间,术后并发症的发生率及肿瘤复发率差异均无统计学意义。结论:NCT可使患者住院时间、手术时间及拔除尿管时间均缩短,NCRT可使肿瘤标志物有明显下降,从数字上看其5年生存率高于术前单纯化疗。

OBJECTIVE To compare the clinical effects of neoadjuvant chemotherapy(NCT)and neoadjuvant chemoradiotherapy(NCRT)combined with surgery for rectal cancer by multidisciplinary diagnosis.METHODS The clinical data of patients with locally advanced rectal cancer(LARC)admitted to the Department of Colorectal and Anal Surgery of Shanxi Cancer Hospital between April 2012 and April 2013 were retrospectively analyzed..The patients were divided into NCRT group(neoadjuvant chemoradiotherapy+surgical treatment)and NCT group(neoadjuvant chemotherapy+surgical treatment)according to their treatment plan,and the treatment effects of the 2 groups were compared through a multidisciplinary approach.SPSS version 22.0 was used for data analysis.RESULTS here were significant differences in the length of hospital stay,operation time and the time to remove the urinary catheter between the two groups.No statistical difference was observed between two groups with regard to the type of operation,the time to remove stomach tube and drainage tube,venting,feeding,activity time after surgery and the incidences of postoperative complications as well as tumor recurrence rate.CONCLUSION NCT treatment could shorten patients’period of hospital stay,operation time and the time to remove urinary catheter.However,the tumor marker has declined dramatically after NCRT treatment.In addition,the 5 year survival rate of NCRT group was better than that of NCT group.