术前FOLFOX4方案同步放射治疗局部晚期直肠癌疗效观察  

Curative effect of preoperative FOLFOX4 regimen combined with radiotherapy in the treatment of locally advanced rectal cancer

作　　者：韦彦斌 车宇 WEI Yan-bin;CHE Yu(Department of Radiotherapy,Yulin Second Hospital,Yulin 719000,Shaanxi,CHINA;No.2 Department of Radiotherapy,Shaanxi Provincial Cancer Hospital,Xi'an 710061,Shaanxi,CHINA)

机构地区：[1]榆林市第二医院放疗科,陕西榆林719000 [2]陕西省肿瘤医院放疗二科,陕西西安710061

出　　处：《海南医学》2020年第15期1951-1953,共3页Hainan Medical Journal

基　　金：陕西省延安市科技计划项目(编号:2016CXTD-05)。

摘　　要：目的观察术前FOLFOX4方案同步放射治疗局部晚期直肠癌的临床疗效。方法选取2015年3月至2019年4月在榆林市第二医院接受治疗的80例T3~T4期结直肠患者作为研究对象,根据化疗方案的不同分为对照组和观察组各40例,所有患者行全直肠系膜切除术,对照组术前给予放射治疗,观察组术前给予FOLFOX4方案同步放射治疗。比较两组患者的近期临床疗效、不良反应、手术切除率、手术并发症和术后1年生存情况。结果观察组患者的治疗总有效率为82.5%,明显高于对照组的60.0%,差异具有统计学意义(P<0.05);观察组放化疗期间的骨髓抑制、神经毒性、恶心、呕吐、手足综合征、白细胞减少症、皮肤黏膜反应等不良反应发生率稍高于对照组,但差异无统计学意义(P>0.05);观察组患者的手术肿瘤切除率和保肛率分别为77.5%、57.5%,明显高于对照组的55.0%、35.0%,差异均具有统计学意义(P<0.05),但两组患者的手术并发症发生率比较差异无统计学意义(P>0.05);两组患者术后1年随访,均无失访病例,观察组患者术后1年的局部复发率为20.0%,明显低于对照组的42.5%,差异具有统计学意义(P<0.05);观察组术后1年的远处转移率为15.0%,稍低于对照组的30.0%,差异均无统计学意义(P>0.05);观察组患者术后1年的生存率为82.5%,明显高于对照组的62.5%,差异具有统计学意义(P<0.05)。结论术前FOLFOX4化疗方案同步放射治疗可提高局部晚期直肠癌患者的近期临床疗效,并未增加放化疗期间的重度不良反应和手术并发症,可提高患者的肿瘤切除率和保肛率,降低术后1年的复发率和死亡率。Objective To observe the clinical effects of preoperative FOLFOX4 regimen combined with radiotherapy in the treatment of locally advanced rectal cancer.Methods A total of 80 patients with colorectal cancer at stage T3-T4 who were treated in Yulin Second Hospital from March 2015 to April 2019 were enrolled as the research subjects.The patients were divided into the control group and observation group according to the chemotherapy regimen,with 40 patients in each group.All patients were treated with total mesorectal excision.Patients in the control group were treated with radiotherapy,while those in the observation group were treated with oxaliplatin,fluorouracil,and leucovorin(FOLFOX4)regimen combined with radiotherapy before surgery.The short-term clinical effect,adverse reactions,surgical resection rate,surgical complications,and postoperative 1-year survival were compared between the two groups.Results The total treatment response rate of observation group was significantly higher than that of control group(82.5%vs 60.0%,P<0.05).The incidence rates of adverse reactions such as myelosuppression,neurotoxicity,nausea,vomiting,hand-foot syndrome,leukopenia and skin mucosa reactions in observation group during chemoradiotherapy were slightly higher than those in control group(all P>0.05).The tumor resection rate and anus preservation rate in observation group were significantly higher than those in control group(77.5%vs 55.0,57.5%vs 35.0%,all P<0.05).There was no significant difference in incidence of surgical complications between the two groups(P>0.05).Both groups were followed up for 1 year after surgery,without any case lost to follow-up.The postoperative 1-year local recurrence rate in observation group was significantly lower than that in control group(20.0%vs 42.5%,P<0.05),and the postoperative 1-year distant metastasis rate was slightly lower than that in control group(15.0%vs 30.0%,P>0.05).The postoperative 1-year survival rate in observation group was significantly higher than that in control group(82.5%vs

关 键 词：直肠癌 FOLFOX4化疗方案 放射治疗 疗效 不良反应 

分 类 号：R735.37[医药卫生—肿瘤]