结直肠癌术后早期应用FOLFOX方案辅助化疗的临床评价  

Clinical Evaluation of FOLFOX Regimen Early Application as Adjuvant Chemotherapy for Colorectal Cancer after Operation

作　　者：左明[1] 刘宝善[1] 徐琳[1] 燕锦[1] 刘超[1] 

机构地区：[1]四川省肿瘤医院,四川成都610041

出　　处：《中国肿瘤》2007年第3期204-207,共4页China Cancer

摘　　要：[目的]探讨结直肠癌术后早期应用奥沙利铂联合5-Fu/甲酰四氢叶酸辅助化疗的安全性和有效性。[方法]89例根治术后的Ⅱ、Ⅲ期结直肠癌患者随机分为2组,早期化疗组与对照组分别于术后第1天和术后1个月开始辅助化疗,应用奥沙利铂联合5-Fu/甲酰四氢叶酸(FOLFOX方案),观察两组术后并发症、术后肠道功能恢复时间、切口愈合状况和化疗毒副反应发生情况及住院时间。[结果]两组手术及辅助化疗期间无死亡病例,无术后出血,无吻合口瘘。早期化疗组腹壁切口平均拆线时间10.56±2.72天,对照组10.31±2.87天,两组间无明显差异(P>0.05)。切口愈合状况无明显差异,术后胃肠道功能恢复时间,早期化疗组:61±10.5小时,对照组:65±11.2小时,两组之间无明显差异(P>0.05)。早期化疗组术后第1个周期,约1/2出现周围神经毒性症状;有15.2%出现恶心(Ⅰ度)、偶有呕吐(Ⅱ度),无Ⅱ度以上腹泻发生,白细胞、血小板、血红蛋白减少不明显,术后1个月内两组各时间点对应白细胞减少比较无显著性差异(P>0.05)。完成全疗程化疗后,两组毒副反应发生情况基本相同。[结论]结直肠癌术后早期应用奥沙利铂联合5-Fu/甲酰四氢叶酸(FOLFOX方案)辅助化疗,不会影响患者切口愈合能力和增加术后并发症,对患者的功能恢复影响不大,对延长结直肠癌患者的生存期,减少术后复发可能会起到积极的作用。[Purpose] To investigate the safety and efficacy of early application of oxaliplatin combined with 5-Fu/leucovorin as adjuvant chemotherapy for colorectal cancer after operation.[Methods] Eighty-nine cases with stage Ⅱ,Ⅲ colorectal cancer were randomized into two groups：early chemotherapy group and control group.The early chemotherapy group received adjuvant chemotherapy of oxaliplatin combined with 5-Fu/leucovorin on the first postoperative day;while the control group received adjuvant chemotherapy after a month.Postoperative complications,gastrointestinal function recovering time,wound healing and side effect of chemotherapy in the two groups were reviewed.[Results]No death case was related to colorectomy and aajuvant chemotherapy.There was no postoperative bleeding and anastomotic leakage.Stitches were took out of the wound at 10.56±2.72 days fearly chemotherapy group） and 10.31±2.87 days （control group） （P〉0.05）.The healing condition of wound and gastrointestinal function recovering time showed no significant difference between two groups （P〉0.05）.Chemotherapy induced nausea （Ⅰ°） and vomiting （Ⅱ°） were reported in 15.2% of patients,and neurosensory symptoms and neurotoxicity occurred in 50% of patients in the early chemotherapy group during first cycle.Leucocytopenia,thrombocytopenia,hemoglobin abatement and over Ⅲ° diarrhoea presented rarely.The incidence of leucocytopenia showed no significant difference between two groups in a month of postoperative period （P〉0.05）.The incidence of the adverse events was similar both in the early chemotherapy groups and control groups after whole cycles.[Conclusion]Early application of adjuvant chemotherapy （FOLFOX regimen） for colorectal cancer has no influence on the patients,wound healing,function recovering and will not increase the incidence of complication after redical colorectomy.It may positively improve long term survival and decrease the recurrence.

关 键 词：结直肠肿瘤 术后辅助化疗 临床评价 FOLFOX方案 

分 类 号：R730.53[医药卫生—肿瘤] R735.3[医药卫生—临床医学]