65例Ⅲ期大肠癌辅助化疗后生存分析  

Survival analysis of 65 cases with stage Ⅲ colorectal cancer on adjuvant chemotherapy

作　　者：肖宇[1] 马力文[1] 梁莉[1] 张淑兰[1] 张照辉[1] 王墨培[1] 曹宝山[1] 

机构地区：[1]北京大学第三医院肿瘤中心,北京100083

出　　处：《临床肿瘤学杂志》2007年第7期529-531,共3页Chinese Clinical Oncology

摘　　要：目的:分析65例Ⅲ期大肠癌术后并辅助化疗后的复发及转移情况,并对比分析应用含奥沙利铂(L-OHP)方案及含羟基喜树碱(HCPT)方案化疗对患者生存期的影响。方法:对65例术后辅助化疗后Ⅲ期大肠癌患者采用Kaplan-Meier法绘制生存曲线,运用时序检验Log-rank进行统计学显著性分析。结果:65例患者中位观察期34个月,辅助化疗后中位无病生存期21个月,累积3年生存率57.2%,累积3年无病生存率45.9%。首先发现的转移器官中,肺转移发生率10.8%(7/65),中位发病时间为9个月,肝转移发生率20.0%(13/65),中位发病时间为11个月,局部复发或其他部位转移发生率15.4%(10/65),中位发生时间为9个月,同时发现多器官转移发生率10.8%(7/65),中位发生时间为11个月。29例患者接受L-OHP+CF/5-FU方案辅助化疗,累积3年生存率为57.4%,3年无病生存率为40.0%。36例患者接受HCPT+CF/5-FU+DDP辅助化疗,累积3年生存率为58.3%,3年无病生存率为46.1%。两组之间差异无统计学意义(P>0.05)。结论:Ⅲ期大肠癌术后较易发生肝转移,术后可根据情况制定合理的随诊方案。以CF/5-FU为基础联合L-OHP或HCPT的辅助化疗方案,两组之间生存期差异无显著性。Objective：To analyze the surveillance after adjuvant chemotherapy for patients with resected stage Ⅲ colorectal cancer. Methods：From 1999 to 2004,65 cases of patients with resected stage Ⅲ colorectal cancer diagnosed by hiStology received chemotherapy with leucovorin/fluorouracil puls oxaliplatin or leucovorin/fluorouracil puls hydroxycamptothecin and cisplatin with a median follow-up of 34 months. Time-to-events curves were calculated by the method of Kaplan and Meier. Results ：The median disease-free-survival of all the patients were 21.0 months,The accum 3-year disease-free survival rate was 45.9% in the 65 patients with the accum 3-year survival rate of 57.2%. The first acquired incidence rate of liver metastases, lung metastases, local recurrence or other parts metastases and multi-parts metastases was 20. 0% （ 13/65 ）, 10. 8% （ 7/65 ）, 15.4% （ 10/65 ）, 10. 8% （ 7/65 ）, and the median time to events were 11. Omonths,9. Omonths, 9. 0 months and 11.0 months. A total of 29 patients received adjuvant chemotherapy with CF/5-FU puls L-OHP and 36 patients were treated with CF/5-FU plus HCPT and DDP. There was no significant difference between the two arms in accum 3-year disease-free survival rate （ 40. 0% vs. 46. 1% , P = 0. 55 ） and accum 3-year survival rate （ 57.4% vs. 58.3%, P =0. 52）. Conclusion：The usual sites of systemic relapse of resected stage Ⅲ colorectal cancer tend to be in the liver,the lung and regional part. There was no significant difference between the adjuvant chemotherapy with CF/5-FU and L-OHP or CF and 5- FU, HCPT and DDP in efficacy to the disease with accum 3-year overall and disease-free survival.

关 键 词：大肠癌 辅助化疗 生存分析 

分 类 号：R735.34[医药卫生—肿瘤]