中晚期直肠癌新辅助治疗评价  

Evaluation of neoadjuvant therapy for middle-late rectal cancer

作　　者：袁维堂[1] 郑豪[1] 宋军民[1] 

机构地区：[1]郑州大学第一附属医院肛肠外科,450052

出　　处：《中国实用医刊》2013年第11期19-20,共2页Chinese Journal of Practical Medicine

摘　　要：目的评估新辅助治疗对中晚期直肠癌患者的近期疗效及对术后恢复的影响。方法2011年11月至2012年10月期间郑州大学第一附属医院肛肠外科收治的66例中晚期直肠癌患者随机分为两组，接受新辅助治疗组和未接受新辅助治疗（首选手术）组各33例，新辅助治疗组患者中，接受全身化疗FOLFOX6方案者20例，FOLFOX6方案化疗加分割方案放疗方案（5×5Gy／次，5次／周，有效生物计量≥30Gy）者10例，单纯行分割放疗者2例，5一氟尿嘧啶动脉灌注化疗1例。通过CT、MRI或超声内镜及手术切除肿瘤的病理检查评价新辅助治疗的疗效，以术后并发痘发生率及术后排气、进食、住院时间评价新辅助治疗对患者术后恢复的影响。结果在新辅助治疗组中，术后病理完全缓解l例，影像学显示肿瘤缩小且术后病理发现部分肿瘤组织坏死或纤维化15例，影像学未见肿瘤缩小但病理发现部分肿瘤细胞坏死或纤维化12例，总有效率为84．85％（28／33），其中5例低位直肠癌患者由于降期幅度大由Miles手术改为行Dixon手术；5例患者肿瘤有不同程度的进展。所有患者术后均未出现吻合口瘘，新辅助治疗组腹部切口感染l例，经换药处理后愈合。两组患者术后排气时间、进食时间、术后住院时间比较差异均无统计学意义。结论新辅助治疗可使肿瘤缩小，降低肿瘤病理分期，提高手术切除率，增加保肛率，对手术及患者术后恢复并无影响。Objective To study the effect and postoperative recovery of the neoadjuvant therapy for middle-late rectal cancer. Methods This paper collected 66 cases of middle-late rectal cancer pa- tients, including new adjuvant therapy 33 cases as a new auxiliary treatment group, and not to accept the new auxiliary treatment of colorectal cancer patients middle-late 33 cases as control group. Compared the postoperative recovery effect of the patients between the two groups. Results The effective rate of neoad- juvant therapy was 84.85% , accept the new auxiliary treatment group patients pathological complete re- mission in 1 case, part of ease in 15 cases, stationary phase in 12 cases, 5 cases progress period. Two groups of patients＇ postoperative recovery： exhaust time （P = 0. 301）, the meal time （P = 0. 088）, and postoperative hospitalization time （P = 0. 471 ）, and there were no statistical significance. Conclu- sions Neoadjuvant therapy can reduce tumor pathological staging, improve surgical excision rate, and it＇ s safe for the operation and the postoperative recovery.

关 键 词：新辅助治疗 中晚期直肠癌 

分 类 号：R735.37[医药卫生—肿瘤]