CAJ | 학술논문

目的:观察结直肠癌肝转移患者中应用新辅助化疗的临床效果及安全性.方法:选取2013年7月-2015年7月期间于苏州永鼎医院肿瘤科收治的结直肠癌肝转移患者40例,采用单纯FOLFIRI方案者3例, FOLFOX6方案者27例,两种方案联合应用10例.获得手术条件后停止化疗至少15 d后方可进行手术治疗,开腹或腹腔镜下切除原发灶,开腹手术切除肝转移灶.结果:新辅助化疗对转移灶有效率67.5%(27/40),对原发灶有效率55.0%(22/40).治疗前血清CEA阳性率85.0%(34/40),接受新辅助化疗后血清CEA阳性率为47.5%(19/40),新辅助化疗前后血清CEA阳性率比较差异有统计学意义( 字2=5.774,P<0.05),同时血清CEA值比较差异有统计学意义(t=15.745,P<0.05).新辅助化疗前原发灶平均大小(2.16±0.51)cm,化疗后平均大小(1.30±0.44)cm,化疗前后比较差异有统计学意义(t=4.084,P<0.05).新辅助化疗前转移灶平均大小(7.64±2.18)cm,化疗后平均大小(3.97±1.15)cm,化疗前后比较差异有统计学意义(t=9.004,P<0.05).14例(35.0%)患者获得根治性切除术,其中1例患者发生切口感染,1例患者发生肝功能衰竭,并发症发生率为5.0%,无患者发生围手术期死亡.结论:随着肝脏外科手术技术的进一步发展以及新辅助化疗方面研究的进一步深入,新辅助化疗在改善结直肠癌肝转移患者预后中扮演越来越重要的角色.
목적:관찰결직장암간전이환자중응용신보조화료적림상효과급안전성.방법:선취2013년7월-2015년7월기간우소주영정의원종류과수치적결직장암간전이환자40례,채용단순FOLFIRI방안자3례, FOLFOX6방안자27례,량충방안연합응용10례.획득수술조건후정지화료지소15 d후방가진행수술치료,개복혹복강경하절제원발조,개복수술절제간전이조.결과:신보조화료대전이조유효솔67.5%(27/40),대원발조유효솔55.0%(22/40).치료전혈청CEA양성솔85.0%(34/40),접수신보조화료후혈청CEA양성솔위47.5%(19/40),신보조화료전후혈청CEA양성솔비교차이유통계학의의( 자2=5.774,P<0.05),동시혈청CEA치비교차이유통계학의의(t=15.745,P<0.05).신보조화료전원발조평균대소(2.16±0.51)cm,화료후평균대소(1.30±0.44)cm,화료전후비교차이유통계학의의(t=4.084,P<0.05).신보조화료전전이조평균대소(7.64±2.18)cm,화료후평균대소(3.97±1.15)cm,화료전후비교차이유통계학의의(t=9.004,P<0.05).14례(35.0%)환자획득근치성절제술,기중1례환자발생절구감염,1례환자발생간공능쇠갈,병발증발생솔위5.0%,무환자발생위수술기사망.결론:수착간장외과수술기술적진일보발전이급신보조화료방면연구적진일보심입,신보조화료재개선결직장암간전이환자예후중분연월래월중요적각색.
Objective:To observe the effect and safety of neo-adjuvant chemotherapy applied in colorectal cancer with hepatic metastasis treatment.Method:40 patients with colorectal cancer and hepatic metastasis were selected in department of oncology of Yongding hospital of Suzhou from July 2013 to July 2015. 3 cases were given FOLFIRI plan,27 cases were given FOLFOX6 plan and 10 cases were given both plans.Surgical treatment was given chemotherapy stopped after 15 days when operation conditions were obtained. Primary tumor was removed with open operation or laparoscopic surgery and metastatic liver cancer was removed by open operation.Result:The efficient of neo-adjuvant chemotherapy on metastatic lesions was 67.5%(27/40) and primary tumor was 55.0%(22/40). The positive rate of CEA in serum was 85.0%(34/40),while after neo-adjuvant chemotherapy it was 47.5%(19/40),there was statistical difference of positive rate of CEA in serum before and after neo-adjuvant chemotherapy( 字2=5.774,P<0.05),and the difference was statistically significant in serum CEA value between before and after neo-adjuvant chemotherapy (t=15.745,P<0.05). The average size of primary tumor before neo-adjuvant chemotherapy was(2.16±0.51)cm,after neo-adjuvant chemotherapy it was (1.30±0.44)cm,there was statistical difference of primary tumor size(t=4.084,P<0.05).The average size of metastatic lesions before neo-adjuvant chemotherapy was(7.64±2.18)cm, after neo-adjuvant chemotherapy it was(3.97±1.15)cm,there was statistical differences of metastatic lesions size(t=9.004,P<0.05). There were 14 patients (35.0%) given radical resection,1 case of incision infection and 1 case of liver failure,the incidence of complication was 5.0%,there was no perioperative death.Conclusion:With liver surgery improved and study of neo-adjuvant chemotherapy deeper, it is more important of neo-adjuvant chemotherapy for prognosis of colorectal cancer with hepatic metastasis patients.