疑难病杂志
疑難病雜誌
의난병잡지
JOURNAL OF DIFFICULT AND COMPLICATED CASES
2014年
5期
444-447
,共4页
直肠癌,低位%新辅助化疗%FOLFOX4%保肛率%生存率
直腸癌,低位%新輔助化療%FOLFOX4%保肛率%生存率
직장암,저위%신보조화료%FOLFOX4%보항솔%생존솔
Colorectal cancer,lower%Neoadjuvant chemotherapy%FOLFOX4%Sphincter preservation%Survival rate
目的：观察FOLFOX4新辅助化疗方案对老年局限性低位直肠癌患者的近、远期疗效及不良反应。方法选取2008年1月-2011年1月收治的老年局限性低位直肠癌患者68例作为研究对象，随机分为观察组与对照组，每组34例。观察组先采用FOLFOX4方案进行新辅助化疗后再行手术治疗，对照组直接进行手术治疗，记录患者化疗反应情况与化疗前后肿瘤进展，对比2组保肛率及术后近远期疗效。结果观察组新辅助化疗总有效率为61骀．76％（21/34），化疗后肿瘤分期下降。观察组与对照组手术保肛率分别为93．55％、61．76％，差异有统计学意义（ P ＜0．05）；观察组与对照组术后2年累积生存率（0．605±0．079 vs．0．412±0．084）差异有统计学意义（ P ＜0．05）。观察组出现便秘、腹泻、恶心、呕吐、中性粒细胞减少等不良反应的发生率较高，其中3例（8．82％）不耐受而终止化疗。结论术前采用FOLFOX4方案进行新辅助化疗可以显著改善老年局限性直肠癌肿瘤分期，提高手术保肛率与术后近、远期疗效，值得在临床推广使用。
目的：觀察FOLFOX4新輔助化療方案對老年跼限性低位直腸癌患者的近、遠期療效及不良反應。方法選取2008年1月-2011年1月收治的老年跼限性低位直腸癌患者68例作為研究對象，隨機分為觀察組與對照組，每組34例。觀察組先採用FOLFOX4方案進行新輔助化療後再行手術治療，對照組直接進行手術治療，記錄患者化療反應情況與化療前後腫瘤進展，對比2組保肛率及術後近遠期療效。結果觀察組新輔助化療總有效率為61駘．76％（21/34），化療後腫瘤分期下降。觀察組與對照組手術保肛率分彆為93．55％、61．76％，差異有統計學意義（ P ＜0．05）；觀察組與對照組術後2年纍積生存率（0．605±0．079 vs．0．412±0．084）差異有統計學意義（ P ＜0．05）。觀察組齣現便祕、腹瀉、噁心、嘔吐、中性粒細胞減少等不良反應的髮生率較高，其中3例（8．82％）不耐受而終止化療。結論術前採用FOLFOX4方案進行新輔助化療可以顯著改善老年跼限性直腸癌腫瘤分期，提高手術保肛率與術後近、遠期療效，值得在臨床推廣使用。
목적：관찰FOLFOX4신보조화료방안대노년국한성저위직장암환자적근、원기료효급불량반응。방법선취2008년1월-2011년1월수치적노년국한성저위직장암환자68례작위연구대상，수궤분위관찰조여대조조，매조34례。관찰조선채용FOLFOX4방안진행신보조화료후재행수술치료，대조조직접진행수술치료，기록환자화료반응정황여화료전후종류진전，대비2조보항솔급술후근원기료효。결과관찰조신보조화료총유효솔위61태．76％（21/34），화료후종류분기하강。관찰조여대조조수술보항솔분별위93．55％、61．76％，차이유통계학의의（ P ＜0．05）；관찰조여대조조술후2년루적생존솔（0．605±0．079 vs．0．412±0．084）차이유통계학의의（ P ＜0．05）。관찰조출현편비、복사、악심、구토、중성립세포감소등불량반응적발생솔교고，기중3례（8．82％）불내수이종지화료。결론술전채용FOLFOX4방안진행신보조화료가이현저개선노년국한성직장암종류분기，제고수술보항솔여술후근、원기료효，치득재림상추엄사용。
Objective To observe and discuss toxicity and short&long term efficacy of FOLFOX 4 neoadjuvant chem-otherapy scheme in treatment of elderly patient with limited lower rectal carcinoma .Methods Limited lower colorectal cancer elderly patients were selected from January 2008 to January 2011 (68 cases), they were treated as research subjects and were randomly divided into observation group and control group , 34 cases in each group .Observation group treated with FOLFOX 4 neoadjuvant chemotherapy after surgical treatment , control group directly underwent surgical treatment .Cases'tumor progres-sion in patients with chemotherapy before and after chemotherapy were recorded , compared two groups sphincter preservation , near and long-term outcome .Results Neoadjuvant chemotherapy observation group total effective rate was 61 .76% ( 21/34), decreased tumor staging after chemotherapy .Observation group and control group sphincter preserving surgery rates were 93.55%and 61.76%, and the difference was statistically significant ( P <0.05);observation group and control group after 2 -year cumulative survival rate's (0.605 ±0.079 vs.0.412 ±0.084) difference was statistically significant ( P <0.05). Observation group had a higher incidence of constipation , diarrhea, nausea, vomiting, neutropenia and other adverse reac-tions, including three cases ( 8.82%) intolerance terminated chemotherapy .Conclusion Using preoperative neoadjuvant chemotherapy with FOLFOX4 significantly improved the limited of colorectal cancer staging , improve sphincter preservation surgery and postoperative short , long-term effect.
