卡培他滨联合奥沙利铂术前新辅助化疗对结肠癌的临床疗效

摘要

目的:研究卡培他滨联合奥沙利铂术前新辅助化疗对结肠癌手术患者的疗效和安全性.方法:将80例结肠癌患者随机分为两组,对照组患者给予手术治疗和术后辅助化疗,观察组患者给予卡培他滨联合奥沙利铂新辅助化疗、手术治疗和术后辅助化疗;比较入院时及手术前两组患者癌胚抗原(CEA)水平、肿瘤最大径、肿瘤分期、阳性淋巴结数,观察两组患者手术时间、术中出血量、腹腔感染率、吻合口瘘发生率、术后首次排气时间和术后住院时间,观察两组患者不良反应发生率和预后,随访3年,观察两组患者的复发率及死亡率.结果:两组患者入院时肿瘤位置、CEA、临床分期比较,差异无统计学意义(P＞0.05),观察组患者经新辅助化疗后,肿瘤缩小、CEA水平下降、病理分期降低、阳性淋巴结数减少,与对照组比较差异具有统计学意义(P＜0.05);两组的手术时间、术中出血量、腹腔感染率、吻合口瘘发生率、术后首次排气时间和术后住院时间相比,差异无统计学意义(P＞0.05);随访3年,观察组患者的复发率和死亡率与对照组比较均明显降低(P＜0.05).结论:卡培他滨联合奥沙利铂对结肠癌患者术前新辅助化疗是安全有效的,可明显降低手术患者肿瘤的临床分期及手术后的复发率和死亡率.%Objective:To investigate the clinical efficacy of neoadjuvant chemotherapy of capecitabine and oxaliplation for the colon carcinoma.Method:80 patients were randomly divided into two groups (n =40).The patients in the observation group were treated with neoadjuvant chemotherapy using capecitabine and oxaliplation,surgical treatment and postoperative adjuvant chemotherapy;the patients in the control group were directly treated with surgical treatment and postoperative adjuvant chemotherapy.Comparing CEA level,tumor size,neoplasm staging,number of positive nymph nodes of both groups at the time of admitting to hospital and before surgery;observing surgery time,blood loss during surgery,abdominal cavity infection rate,anastomotic leak incidence rate,first exhaustion time after surgery and hospitalization time after surgery;observing adverse reaction incidence rate and prognosis,follow-up visit for 3 years,and observe the recurrence rate and mortality rate.Results:Comparing tumor location,CEA and clinical staging of both groups while admitted to hospital,differences were not statistically significant (P ＞ 0.05);after neoadjuvant chemotherapy,tumor shrunk,CEA level decreased and clinical staging decreased,number of positive nymph nodes decreased in the observation group,differences were statistically significant(P ＜ 0.05).Comparing surgery time,blood loss during surgery,abdominal cavity infection rate,anastomotic leak incidence rate,first exhaustion time after surgery and hospitalization time after surgery of both groups,differences were not statistically significant (P ＞ 0.05);during the 3 years follow-up visit,recurrence rate and mortality rate of observation group were significant decreased comparing with control group (P ＜ 0.05).Conclusion:The neoadjuvant chemotherapy combined capecitabine and oxaliplation for treating patients with colorectal cancer was effective and safe,and it can significantly decrease the clinical staging and recurrence rate and mortality rate.