老年高危Ⅱ期和Ⅲ期结直肠癌根治术后辅助化学治疗效果观察  

Observation of Curative Effect of Adjuvant Chemotherapy in Elderly Patients with High-Risk Stage Ⅱ and Stage Ⅲ Colorectal Cancer after Radical Resection Surgery

作　　者：俞春波 徐庆[1] 陈锦先[1] 陶淑芳 

机构地区：[1]上海交通大学医学院附属仁济医院胃肠外科,上海200127 [2]上海市安亭医院普外科,上海201805 [3]上海市安亭医院病理科,上海201805

出　　处：《临床误诊误治》2014年第11期105-108,共4页Clinical Misdiagnosis & Mistherapy

基　　金：2010年上海市卫生局基金项目(2010160)

摘　　要：目的观察老年高危Ⅱ期和Ⅲ期结直肠癌根治术后辅助化学治疗的临床效果和不良反应。方法选取2011年7月—2012年12月在我院住院治疗的老年高危Ⅱ期和Ⅲ期结直肠癌523例,根据患者及其家属是否同意化学治疗分为化学治疗组(230例)和非化学治疗组(293例),化学治疗方案为FOLFOX方案(氟尿嘧啶+奥沙利铂+亚叶酸钙)、XELOX方案(奥沙利铂+卡培他滨)和SOX方案(奥沙利铂+替吉奥胶囊),比较两组术后1年和2年的无病生存率、总复发和转移率及无病生存期,并观察化学治疗组不良反应发生情况。结果 523例均完成研究。化学治疗组无病生存期长于非化学治疗组,术后2年总复发和转移率低于非化学治疗组,术后2年无病生存率高于非化学治疗组,两组比较差异均具有统计学意义(P<0.05)。Kaplan-Meier生存曲线分析结果显示两组术后2年无病生存率比较差异有统计学意义(P<0.05)。化学治疗组出现的不良反应主要有消化系统反应、骨髓抑制、肝功能损害、外周神经毒性及手足综合征,但经对症处理后患者多可耐受,不影响治疗。结论老年高危Ⅱ期和Ⅲ期结直肠癌根治术后辅助化学治疗效果良好,且患者耐受性较好。Objective To observe the efficacy and side effects of adjuvant chemotherapy in elderly patients with high-risk stage Ⅱ and stage Ⅲ colorectal cancer after radical resection surgery. Methods A total of 523 patients with high-risk stage Ⅱ and stage Ⅲ colorectal cancer were selected in our hospital during July 2011 and December 2012. With informed consent of the patients and their family members, they were divided into chemotherapy group （n=230） and non-chemotherapy group （n=293）. The patients in chemotherapy group were assigned to receive FOLFOX regimen （fluorouracil plus oxaliplatin and calcium folinate） , XELOX regimen （ oxaliplatin plus capecitabine） or SOX regimen （ oxaliplatin plus S-1 capsule） . The difference of disease-free survival （ DFS） , tumor relapse and metastasis rates in two groups were analyzed one year and two years after surgery, and side effects of chemotherapy group were observed. Results All the patients completed the following up. Disease-free survival time of the chemotherapy group was longer than that of the non-chemotherapy group, the 2-year total relapse and metastasis rates of the chemotherapy group were lower than those of the non-chemotherapy group, and the 2-year disease-free survival rate of the chemotherapy group was higher than that of the non-chemotherapy group, and the differences were all statistically significant （ P〈0. 05 ） . Kaplan-Meier survival analysis showed significant difference of 2-year DFS rate between the two groups （P〈0. 05）. Major adverse effects of the chemotherapy group were gastrointestinal disturbance, bone marrow suppression, liver dysfunction, peripheral neuropathy and hand-foot syndrome. After symptomatic treatment, all pa-tients could tolerate without effect of treatment. Conclusion Adjuvant chemotherapy maintains better efficacy in elderly pa-tients with high-risk stage Ⅱ and stage Ⅲ colorectal cancer after radical resection surgery, and could be better tolerated.

关 键 词：老年人 结直肠肿瘤 化学治疗 

分 类 号：R735.34[医药卫生—肿瘤]