157例中晚期大肠癌术后化疗的疗效观察  

Therapeutic effect of postoperative chemotherapy in 157 patients with advanced colorectal cancer

作　　者：陈领弟 陈洁华 周晓聪 CHEN Lingdi;CHEN Jiehua;ZHOU Xiaocong(Department of Colorectal,Wenzhou Central Hospital in Zhejiang Province,Wenzhou325000,China)

机构地区：[1]浙江省温州市中心医院大肠科

出　　处：《中国现代医生》2020年第1期97-100,103,共5页China Modern Doctor

基　　金：浙江省卫生科技计划项目（2017KY622）;浙江省温州市公益性科技计划项目（Y20160541）

摘　　要：目的 探讨中晚期大肠癌术后化疗的临床疗效。方法 回顾性选取2012年1月~2017年12月我院接收的中晚期大肠癌患者,所有患者均经根治手术病理诊断分期为Ⅲ期的中晚期大肠癌患者,排除术前新辅助化疗及术后进行同步放化疗的病例。通过查看患者住院病例、住院医嘱、出院诊断、门诊随访影像学检查、肿瘤标志物CEA值等资料,记录患者年龄、性别、CEA值、化疗次数、化疗药物及肿瘤复发等信息,术后化疗随访时间为3年。根据无瘤生存时间将患者分为≤1年组、>1年,且<3年组及≥3年组,统计分析患者年龄、CEA水平、化疗药物及治疗次数等与患者无瘤生存时间之间的相关性。结果 共选取157例中晚期大肠癌患者,无瘤生存时间≤1年的患者31例(19.7%),>1年,且<3年患者45例(28.7%),≥3年患者81例(51.6%);患者无瘤生存时间与患者年龄无显著相关性(P>0.05),患者≥3年无瘤生存时间与CEA值显著相关(P<0.05)。无瘤生存时间≥3年的患者化疗次数进行比较,差异有统计学意义(P<0.05)。结论 中晚期大肠癌术后化疗实施率高,临床疗效不确定;化疗前患者身体各项机能评估至关重要是决定患者术后无瘤生存时间长短的重要因素。Objective To explore the clinical effect of postoperative chemotherapy for advanced colorectal cancer.Methods Patients with advanced colorectal cancer received from January 2012 to December 2017 in our hospital were retrospectively selected.All patients were those with advanced colorectal cancer who underwent radical surgery for stageⅢdiagnosis,excluding preoperative neoadjuvant chemotherapy and concurrent chemoradiotherapy after surgery.By reviewing the patient's hospital cases,hospital medical order,discharge diagnosis,and outpatient follow-up imaging examination and tumor marker CEA value,the patient's age,gender,CEA value,number of chemotherapy treatments,chemotherapy drugs,and tumor recurrence were recorded.The postoperative chemotherapy follow-up period was 3 years.According to the tumor-free survival time,patients were divided into<1 year group,>1 years,<3 years group and≥3 year group.The correlation between patient age,CEA level,chemotherapy drugs,treatment times and patient-free survival time was statistically analyzed.Results A total of 157 cases of advanced colorectal cancer were selected.There were 31 patients(19.7%)with tumor-free survival time≤1 year,45 patients(28.7%)with>1 years,<3 years,and 81 patients with(51.6%)≥3 years.There was no significant correlation between the tumor-free survival time and the patient's age(P>0.05).The≥3 year tumor-free survival time was significantly correlated with CEA(P<0.05).There was a statistically significant difference in different chemotherapy times of patients with postoperative chemotherapy for≥3 years(P<0.05).Conclusion The implementation rate of postoperative chemotherapy for advanced colorectal cancer is high,and the clinical efficacy is uncertain.The evaluation of various functions of patients before chemotherapy is very important,and it is also an important factor in determining the length of time after surgery.

关 键 词：大肠癌 化疗 无瘤生存时间 卡培他滨 

分 类 号：R735.34[医药卫生—肿瘤]