新辅助化疗对直肠癌手术的影响  

Impact of Neo-adjuvant Chemotherapy on the Efficacy of Operation for Rectal carcinoma

作　　者：胡凌 唐迎春 

机构地区：[1]武汉市第十一医院。湖北武汉430015 [2]武汉市第八医院,湖北武汉430016

出　　处：《中国肛肠病杂志》2011年第12期16-18,共3页Chinese Journal of Coloproctology

摘　　要：为探讨新辅助化疗对直肠癌手术的影响，并比较FOI，FOX4方案和5-FU／LV方案在直肠癌新辅助化疗中的效果。本研究采用随机对照研究方法，将2006年5月至2010年5月我院收治的拟行手术治疗的67例直肠癌患者随机分为A、B、C组，A组21例患者术前接受FOL FOX4方案化疗，B组22例患者术前接受5-FU／LV方案化疗，C组24例患者在完善术前检查、排除手术禁忌症后即行手术治疗，对比分析A、B组化疗前后肿块临床触诊情况、直肠镜检评价情况，以及三组手术情况和术后复发情况。结果显示，化疗2个周期后，A组完全缓解（cR）1例，部分缓解（PR）11例，疾病稳定（SD）9例；B组CR0例，PR13例，SD9例，两组总有效率（CR＋PR）比较差异无统计学意义，P〉0．05。A、B、C组保肛术后分别复发1例（4．8％）、1例（4．5％）和3例（12．5％）。A、B组与C组相比，复发率差异均有统计学意义，P〈0．05；A、B组差异无统计学意义，P〉0．05。三组术后切口感染、吻合口漏发生率差异无统计学意义，P〉0．05。结果表明，FOI。FOX4方案和5-FU／LV方案行新辅助化疗均可缩小直肠原发肿瘤，且不增加术后并发症发生率，效果满意，但两者效果无明显差异。The objective of this study was to investigate the influence of neo-adjuvant chemotherapy on the efficacy of operation for rectal carcinoma, and compare the efficacies of FOLFOX4 schema and 5-FU/LV schema,by using random control method. In this study 67 rectal carcinoma patients admitted from May, 2006 yr. to May,2010 yr. in author＇s hospital were randomly divided into three groups：A,B,C group;A group（ n =21） was subject to FOLFOX4 schema,B group（ n =22） to 5-FU/LV schema, preoperatively, while C group（ n = 24） just received operation once following preoperative examination and excepting operative contraindication; and,the following items of the 3 groups were compared and analysed, including the clinical palpation and rectoscopy status on neoplasm mass before and after chemotherapy,and the operative and postoperative recurrence status. As results,after two cycles of chemotherapy in A group,one case was CR, 11 cases PR, 9 cases SD; in B group, respectively 0 case, 13 cases, 9 cases; between the total effective rates（CR＋PR） of two groups there was no statistical difference（ P 〉0.05）. After anus-preserved procedure recurrence case numbers in A, B, C group was 1 （4.8 %）, 1 （4.5 %）, 3 （ 12.5 % ） respectively; C group was compared with A group, and with B group in recurrence rate there was statistical difference（ P〈0.05） ,but there was no statistical difference between A and B groups（ P 〉0.05）. In incidences of wound infection,stoma leakage there was no statistical difference among the three groups（ P 〉0.05）. Results show that performing FOLFOX4 and 5-FU/LV schema＇s neo-adjuvant chemotherapy can all decrease primary neoplasms of rectum, and does not increase postoperative incidence of complication with satisfactory outcome;but the efficacy two schemas do not have significant difference.

关 键 词：直肠癌 新辅助化疗 FOLFOX4方案 5-FU/LV方案 疗效 

分 类 号：R737.9[医药卫生—肿瘤]