卡培他滨+奥沙利铂同期放化疗在Ⅱ、Ⅲ期直肠癌根治术后的应用效果  

Efficacy of concurrent radiotherapy and chemotherapy with capecitabine plus oxaliplatin after treatment of stage Ⅱ/Ⅲ rectal cancer

作　　者：俞根华 张军[2] 张海兵[3] 陈永朝[3] 龚旭锋 Gen-Hua Yu;Jun Zhang;Hai-Bing Zhang;Yong-Chao Chen;Xu-Feng Gong(Department of Tumor Radiotherapy, Zhebei Mingzhou Hospital, Huzhou 313000, Zhejiang Province, China;Department of Gastroenterology, Huzhou Central Hospital, Huzhou 313000, Zhejiang Province, Chin;Department of Interventional Radiology, Huzhou Central Hospital, Huzhou 313000, Zhejiang Province, China)

机构地区：[1]湖州浙北明州医院肿瘤放疗科,313000 [2]湖州市中心医院消化内科,浙江省湖州市313000 [3]湖州市中心医院介入放疗科,浙江省湖州市313000

出　　处：《世界华人消化杂志》2018年第12期742-747,共6页World Chinese Journal of Digestology

摘　　要：目的探究卡培他滨联合奥沙利铂同期放化疗在Ⅱ、Ⅲ期直肠癌根治术中的应用效果,为直肠癌根治术后放化疗提供循证依据.方法选取湖州市中心医院2014-09/2015-09收治的Ⅱ、Ⅲ期直肠癌根治术患者共98例,按照随机数表法分为对照组(n=48)与观察组(n=50),对照组接受卡培他滨单药物同期放化疗,观察组接受卡培他滨联合奥沙利铂同期放化疗.比较两组患者放化疗效果、生存指标及不良反应情况.结果观察组放化疗有效率明显高于对照组放化疗有效率(98.0%vs 87.0%,P<0.05).对照组与观察组患者总生存率为(79.2%vs 78.0%,P=0.889),无局部区域复发生存率LR-FS为(91.7%vs 84.0%,P=0.247),无远处转移生存率FDM为(75.0%vs 76.0%,P=0.908),均无显著性差异.在急性毒性反应Ⅰ-Ⅳ级中,观察组食欲下降、恶心、呕吐、放射性肠炎/腹泻的发生率均高于对照组(P<0.05),神经毒性与手足综合征的发生率也高于对照组(P<0.05).在急性毒性反应Ⅲ-Ⅳ级中,观察组呕吐、放射性皮炎发生率高于对照组(P<0.05).结论Ⅱ、Ⅲ期直肠癌根治术后患者使用卡培他滨联合奥沙利铂同期放化疗有较好的效果,但未增加患者的总生存率OS,无局部区域复发生存率LR-FS,无远处转移生存率FDM等生存获益指标,其急性毒性反应发生率较高.AIM To evaluate the clinical effects of concurrent radiotherapy and chemotherapy with capecitabine plus oxaliplatin in patients after radical resection for stage Ⅱ/Ⅲ rectal cancer to provide evidence-based evidence. METHODS Ninety-eight patients who had undergone radical resection for stage Ⅱ/Ⅲ rectal cancer at our hospital from September 2015 to September 2016 were randomly divided into a control group （n = 48） and an observation group （n = 50）. The control group received concurrent radiotherapy and chemotherapy with capecitabine alone, and the observation group received concurrent radiotherapy and chemotherapy with capecitabine plus oxaliplatin. The effect of chemotherapy, survival indexes, and adverse reactions were compared between the two groups. RESULTS The effective rate was significantly higher in the observation group than in the control group （98.0% vs 87.0%, P 〈 0.05）. There was no significant difference in overall survival （OS） rate （79.2% vs 78.0%, P = 0.889）, local recurrence-free survival （LRFS） rate （91.7% vs 84.0%, P = 0.247）, or distant metastasis-free survival （DMFS） rate （75.0% vs 76.0%, P = 0.908） between the control group and observation group. The incidence of grade Ⅰ-Ⅳ acute toxicities such as appetite loss, nausea, vomiting, and radiation enteritis/diarrhea was significantly higher in the observation group than in the control group. The incidence of neurotoxicity and hand foot syndrome in the observation group was also higher than that in the control group （P 〈 0.05）. With regard to grade Ⅲ/Ⅳ acute toxic reactions, the incidence of vomiting and radioactive dermatitis in the observation group was significantly higher than that in the control group （P 〈 0.05）. In patients after radical resection for stage Ⅱ/Ⅲ rectal cancer, although capecitabine plus oxaliplatin chemotherapy has a good effect, it does not improve OS, LR-FS, and FDM rates and is associated with increased incidence of acute digestive and nervous system toxi

关 键 词：卡培他滨 奥沙利铂 直肠癌 放化疗 

分 类 号：R735.37[医药卫生—肿瘤]