术前放疗同期FOLFOX6时辰化疗在局部进展期直肠癌中的应用  

Application study of concurrent radiotherapy and FOLFOX6 chronomodulated chemotherapy for patients with locally advanced rectal cancer in preoperation

作　　者：冯梓贤 曾今诚 吴培信 刘军 王晓亮[1] 钟美霞[1] 

机构地区：[1]廉江市人民医院肿瘤科,广东廉江524400 [2]广东医科大学·广东省医学分子诊断重点实验室,广东东莞523808 [3]廉江市人民医院普通外科,广东廉江524400

出　　处：《西部医学》2017年第7期949-953,957,共6页Medical Journal of West China

基　　金：广东省科技计划项目(2014A020212298);湛江市科技攻关计划项目(2016B01069)

摘　　要：目的探讨术前放疗同期FOLFOX6时辰化疗在局部进展期直肠癌(LARC)中的应用。方法将2012年1月~2016年6月收治的LARC患者分为实验组44例和对照组45例,实验组术前采用三维适形放疗同期FOLFOX6时辰化疗,而对照组术前采用三维适形放疗同期FOLFOX6常规化疗。统计两组的疗效、不良反应、围手术期并发症、肿瘤标志物、免疫功能指标和患者生活质量变化,利用χ2检验等分析相关数据。结果两组患者的保肛率和降期情况类似(P>0.05);实验组的神经毒性、消化道反应、贫血发病率明显低于对照组(P<0.05);两组的癌胚抗原浓度、实验组的糖类抗原19-9浓度和对照组的B细胞比率在术前放化疗后均出现明显下降(P<0.05);实验组的CD4和CD4/CD8在术前放化疗后均出现明显升高(P<0.05);实验组生活质量降低的构成比明显低于对照组(P<0.05)。结论术前放疗同期FOLFOX6时辰化疗的疗效明确,可以降低术前放化疗不良反应,提高免疫力,减轻放化疗对患者生活质量的影响。Objective To investigate the concurrent radiotherapy and FOLFOX6 chronomodulated chemotherapy for patients with locally advanced rectal cancer （LARC） in preoperation. Methods In this study, patients with LARC between January 2012 and June 2016 were included. The patients were divided into experimental group （44 cases） and control group （45 cases）. Therapeutic schedule of experimental group were concurrent three dimensional conformal radia- tion therapy and FOLFOX6 chronomodulated chemotherapy in preoperation, and control group were three dimensional conformal radiation therapy and FOLFOX6 conventional chemotherapy in preoperation. Data was collected on the curative effect, untoward reactions, peroperative complications, tumor marker, immune function index, changes of quality of life. The data of two groups were compared using chi-square test and so on. Results The sphincter preservation rate and downstaging rates in tumor were similarity in the two groups （P〉0.05）. The incidence rate of neurotoxicity, digestive tract reaction, anemia in the experimental group were significantly lower than that in the control group （P〈0.05）. The carcinoembryonic antigen concentration of two groups, CA19-9 concentration of experimental group and B cell percentage of control group were decreased significantly after radiotherapy and chemotherapy in preoperative （P〈0.05）. CD4 per- centage and CD4/CD8 were increased significantly after radiotherapy and chemotherapy in the experimental group in pre-operative （P〈0.05）. The constituent ratio of reduces the life quality of experimental group was significantly lower than that of control group （P〈0.05）. Conclusions The therapeutic effect of concurrent radiotherapy and FOLFOX6 chrono- modulated chemotherapy in preoperation to the treatment of LARC was very significant, this therapeutic schedule can re- duce the rate of preoperative chemoradiation adverse reactions, and also can strengthen immunity and reduce the impact of life quality of patients to c

关 键 词：直肠癌 时辰化疗 三维适形放疗 奥沙利铂 5-氟尿嘧啶 

分 类 号：R735.37[医药卫生—肿瘤]