FOLFOX4新辅助化疗方案在老年局限性低位直肠癌中的应用

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月一2011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 规察组新辅助化疗总有效率为61.76%(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。

FOLFOX4 neoadjuvant chemotherapy in elderly patients with lower colorectal cancer

Objective To observe and discuss toxicity and short long term efficacy of F0LF0X4 neoadjuvant chemotherapy 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 F0LF0X4neoadjuvant chemotherapy after surgical treatment,control group directly underwent surgical treatment.Cases＇ tumor progression 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 were93.55%and 61.76%,and the difference was statistically significant（P〈0.05）;observation group and control group after2-year cumulative survival rates（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 reactions,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.