热疗联合化疗治疗晚期结直肠癌的临床疗效

目的 观察热疗联合CapeOx(XELOX)化疗方案治疗晚期结直肠癌患者的有效性和安全性.方法 将80例晚期结直肠癌患者按随机表法分为单纯组(化疗)及联合组(化疗+热疗),每组40例.单纯组接受CapeOx(XELOX)方案化疗,联合组在接受CapeOx(XELOX)方案化疗的基础上同期在化疗的第1、5、10天进行热疗.用RECIST评价标准评价治疗后的疗效,观察肿瘤标记物癌胚抗原(CEA)变化和不良反应发生率,统计生存率.结果 联合组完全缓解(CR)+部分缓解(PR)率为67.5％(27/40),高于单纯组的35.0％(14/40),差异有统计学意义(P＜0.05).治疗后两组CEA水平均下降,且联合组低于单纯组[(101.3±58.1) vs (213.6±100.3) ng/mL,P＜0.05].联合组白细胞下降、胃肠道反应、周围神经毒性反应等不良反应发生率低于单纯组(P＜0.05).联合组与单纯组患者的2个月生存率均为100％(40/40),差异无统计学意义(P＞0.05);联合组2年生存率为37.5％(15/40),高于单纯组的12.5％(5/40),差异有统计学意义(P＜0.05).结论 热疗联合化疗可以更有效地控制晚期结直肠癌的肿瘤生长,延长患者生存期,降低化疗不良反应发生率,是一种有效、安全的治疗方法.

Clinical effect of chemotherapy combined with hyperthermia for treatment of patients with advanced colorectal cancer

Objective To evaluate the safety and efficacy of CapeOx(XELOX) chemotherapy combined with hyperthermia in treating patients with advanced colorectal cancer. Methods A total of 80 patients with advanced colorectal cancer were evenly randomized into two groups: the combined group underwent CapeOx (XELOX) chemotherapy and hyperthermia(on the 1^st, 5^th, and 10^th days of chemotherapy), while the control group only received chemotherapy. The treatment efficacies (evaluated by Response Evaluation Criteria in Solid Tumors[RECIST]), serum levels of carcinoembryonic antigen (CEA) and adverse reactions were compared between the two groups. The survival rates of two groups were recorded and analyzed. Results RECIST results showed that the rate of complete remission plus partial remission in combined group was 67.5%(27/40), which was significantly higher than that in the control group (35.0%[14/40], P<0.05). The serum levels of CEA were decreased in both group after treatment, with that in the combined group being significantly lower than that in the control group( [101.3±58.1] vs [213.6±100.3] ng/mL, P<0.05). The adverse reaction(leukocyte decrease, gastrointestinal reaction, and peripheral nerve reaction) rate of the combined group was significantly lower than that in the control group(P<0.05). The 2-month survival rates were 100.0% in both groups (P>0.05); while the 2-year survival rate of the combined group was significantly higher than that in the control group (37.5%[15/40] vs 12.5%[5/40], P<0.05). Conclusion CapeOx (XELOX) chemotherapy combined with hyperthermia is safe and effective to control the growth of advanced colorectal cancer, benefiting the survival and decreasing the adverse reaction.