奥沙利铂联合氟尿嘧啶、甲酰四氢叶酸钙新辅助化疗对进展期直肠癌疗效的研究  

Efficacy of neoadjuvant chemotherapy with oxaliplatin plus fluorouracil and leucovorin (mFOLFOX6) in patients with advanced rectal cancer

作　　者：缪锦超 曾向伟 刘伟业 黄家荣 林晓锋 余立建 蔡世春 MIAO Jin-chao;ZENG Xiang-wei;LIU Wei-ye;HUANG Jiarong;LIN Xiao -feng;YU Li-jian;CAI Shi-chun(Department of General Surgery, Peng Pai Memorial Hospital, Guangdong Province Shanwei 516400, CHINA;Department of Oncology, Peng Pai Memorial Hos-pital, Guangdong Province Shanwei 516400, CHINA)

机构地区：[1]海丰县彭湃纪念医院普外科,广东海丰516400 [2]海丰县彭湃纪念医院肿瘤科,广东海丰516400

出　　处：《消化肿瘤杂志（电子版）》2017年第4期256-259,共4页Journal of Digestive Oncology(Electronic Version)

摘　　要：目的探讨mFOLFOX6(奥沙利铂+氟尿嘧啶+甲酰四氢叶酸钙)两周方案在进展期直肠癌新辅助化疗中的应用疗效。方法选取2012年3月至2013年3月我院确诊收治的94例进展期直肠癌患者随机分为观察组和对照组,每组各47例。所有患者均行直肠癌根治术。观察组患者在手术前行4个疗程的mFOLFOX6新辅助化疗+术后辅助化疗8个疗程,对照组术后进行mFOLFOX6方案辅助化疗12个疗程。比较两组的临床疗效、生存率、手术并发症以及化疗毒性反应等指标。结果观察组患者临床治疗总有效率为59.6%,明显高于对照组36.2%(P<0.05);观察组患者的总生存率和无瘤生存率优于对照组;观察组R0切除率为95.73%,明显高于对照组82.98%(P<0.05)。两组术后并发症以及毒副反应均没有明显差异(P>0.05)。结论奥沙利铂联合氟尿嘧啶、甲酰四氢叶酸钙两周方案(mFOLFOX6)应用于进展期直肠癌的新辅助化疗,疗效确切,能提高患者远期预后,且患者耐受性好,可以在临床上进一步推广应用。Objective To investigat the efficacy of oxaliplatin plus fulorouracil and leucovorin(mFOLFOX6) as neoadjuvant chemotherapy for advanced rectal cancer. Methods From Mar 2012 to Mar2013, 94 patients diagnosed with advanced rectal cancer in our hospital were enrolled in this study, and were randomized into experimental group(n =47) and control group(n =47). All patients received radical resection of rectal cancer. In theexperimental group, patients received four courses of mFOLFOX6 neoadjuvant chemotherapy before surgery and eight courses of adjuvant chemotherapy after surgery. In the control group,patients received 12 courses of mFOLFOX6 chemotherapy after surgery. The clinical efficacy, survival rates,postoperative complications and chemotherapy related adverse events were compared between the two groups.Results The overall clinical efficacy in the observational group was significantly higher than that in the control group(56.9% vs. 36.2%, P<0.05). The overall survival rates and disease-free survival rates were higher in the observational group than those in the control group. The R0 resection rate was 95.73% in the observation group and 82.98% in the control group(P < 0.05). There was no significant difference in the postoperative complications or chemotherapy related adverse events(P >0.05). Conclusion Neoadjuvant mFOLFOX6 chemotherapy may be able to improve the long-term outcomes of the patients with advanced rectal cancer with tolerable toxicity.

关 键 词：新辅助化疗 进展期 直肠癌 疗效 

分 类 号：R735.37[医药卫生—肿瘤]