奥沙利铂联合卡培他滨的新辅助化疗在中低位直肠癌中的应用体会

目的探讨应用奥沙利铂联合卡培他滨的新辅助化疗在中低位直肠癌中的疗效。方法 2012年2月至2014年2月我院收治的112例无远处转移的中低位直肠癌患者,分为试验组(56例)和对照组(56例)。试验组于术前第6周、第3周分别行为期21 d的奥沙利铂联合卡培他滨的新辅助化疗2个疗程,奥沙利铂130 mg/m2(体表面积),第1天用;卡培他滨400 mg/m2,分两次口服,连用14 d,停药7 d。对照组不作任何放、化疗,并记录肿瘤变化、药物副作用以及手术后并发症发生情况。结果试验组55.357%(31/56)的患者肿瘤最长径缩小,与周围组织间隙相对清晰,质地变软。试验组的患者手术保肛率显著高于对照组(P<0.05),淋巴结转移率显著低于对照组(P<0.05),吻合口瘘的发生率并不高于对照组(P<0.05)。结论中低位直肠癌患者术前合理应用奥沙利铂联合卡培他滨的新辅助化疗,可使保肛率显著提高,淋巴结转移率显著降低,而且吻合口瘘的发生率并不增加。

The application of neoadjuvant chemotherapy oxaliplatin plus capecitabine in mid-low rectal carcinoma

Objective To explore the clinical efficacy of neoadjuvant chemotherapy oxaliplatin plus capecitabine（XELOX） in middle-low rectal carcinoma. Methods Between February 2012 and February 2014, 112 patients with middle-low rectal carcinoma at our hospital, no evidence of distant metastases, were included in this study, which were divided into the experimental group（56 cases） and control group（56 cases）. Patients in the experimental group were respectively treated with two cycles XELOX regimen（oxaliplatin 130 mg/m^2 on day 1 with capecitabine 400 mg/m^2 twice daily for 14 days every 3 weeks）, patients in the control group were not given any chemoradiation. Tumor response, toxicities, and surgical complications were recorded. Results The experimental group with tumor size became smaller, more soft, tissue space became more wide, was exhibited in 55.357%（31/56）. The anal sphincter preservation rate in the experimental group was significantly higher than in control group（P〈0.05）, the rate of lymph node metastasis in the experimental group was significantly lower than in the control group（P〈0.05）. Anastomotic leakage rate had significant difference（P〈0.05）. Conclusion Neoadjuvant oxaliplatin plus capecitabine in the treatment of patients with middle-low rectal carcinoma, can significantly improve the rate of anal preservation, the rate of lymph node metastasis was significantly lower, the incidence of anastomotic fistula did not increase.