2019 年第 4 期 第 14 卷

卡培他滨联合奥沙利铂同步放化疗治疗晚期直肠癌患者的临床效果

Clinical effect of concurrent radiotherapy and chemotherapy with capecitabine plus oxaliplatin on advanced rectal cancer

作者：刘彦合李慧叶晓谊李平张泽李长智曾祥勇

英文作者：

单位：570311海口，海南医学院第二附属医院普外科（刘彦合、叶晓谊、李平、张泽、李长智、曾祥勇），老年病科（李慧）

英文单位：

关键词：局部晚期直肠癌；卡培他滨；奥沙利铂；放射治疗

英文关键词：

• 摘要：

• 【摘要】目的    探讨卡培他滨联合奥沙利铂同步放化疗治疗晚期直肠癌患者的临床效果。方法    选取2013年1月至2015年1月海南医学院第二附属医院收治的局部晚期直肠癌患者100例，按照随机数字表法分为对照组和观察组，每组50例。对照组患者采用卡培他滨联合奥沙利铂化疗方案进行治疗；观察组患者在卡培他滨联合奥沙利铂化疗方案基础上进行放射治疗。出院后，对2组患者进行为期3年随访。比较2组患者出院1年后近期临床疗效、随访3年远期生存率、远期复发率、远处转移率及不良反应发生情况。结果    观察组治疗总有效率明显高于对照组［76.0%(38/50)比48.0%(24/50)］，差异有统计学意义（P=0.004）。2组患者随访1年生存率比较差异无统计学意义（P=0.359）；观察组随访2、3年的生存率均明显高于对照组［82.0%(41/50)比52.0%(26/50)、68.0%(34/50)比36.0%(18/50)］，差异均有统计学意义(P=0.001、0.003)。观察组远期复发率及远处转移率均明显低于对照组［24.0%(12/50)比48.0%(24/50)、18.0%(9/50)比44.0%(22/50)］，差异均有统计学意义（P=0.012、0.005）。2组患者干预治疗后恶心呕吐、腹泻、白细胞减少、手足综合征及神经毒性等不良反应发生率比较，差异均无统计学意义（P=0.053、0.523、0.539、0.829、0.667）。结论    采用卡培他滨联合奥沙利铂同步放化疗对局部晚期直肠癌患者进行治疗，能够有效提高患者的近期临床疗效和远期生存率，同时降低远期复发率和远处转移率，且未增加不良反应。

• 【Abstract】Objective    To observe the clinical effect of concurrent radiotherapy and chemotherapy with capecitabine plus oxaliplatin on patients with advanced rectal cancer. Methods    From January 2013 to January 2015, 100 patients with locally advanced rectal cancer admitted to the Second Affiliated Hospital of Hainan Medical University were randomly divided into control group and observation group, with 50 cases in each group. The control group was treated with capecitabine plus oxaliplatin chemotherapy. The observation group was treated with capecitabine plus oxaliplatin chemotherapy combined with radiotherapy. All patients were followed up for 3 years. Short-term clinical effect at 1 year after discharge, 3-year long-term survival rate, recurrence rate, distant metastasis rate and incidence of adverse reactions were analyzed. Results    Total effective rate in observation group was significantly higher than that in control group［76.0%(38/50) vs 48.0%(24/50)］（P=0.004）. There was no significant difference of 1-year survival rate between groups(P=0.359). The 2-year and 3-year survival rates in observation group were significantly higher than those in control group［82.0%(41/50) vs 52.0%(26/50), 68.0%(34/50) vs 36.0%(18/50)］(P=0.001, 0.003). Long-term recurrence rate and distant metastasis rate in observation group were significantly lower than those in control group［24.0%(12/50) vs 48.0%(24/50), 18.0%(9/50) vs 44.0%(22/50)］（P=0.012, 0.005）. Incidences of nausea and vomiting, diarrhea, leucopenia, hand-foot syndrome and neurotoxicity showed no significant difference between groups(P=0.053, 0.523, 0.539, 0.829, 0.667). Conclusion    Capecitabine combined with oxaliplatin concurrent chemoradiotherapy treating locally advanced rectal cancer can effectively improve short-term clinical effect and long-term survival, reduce long-term recurrence and distant metastasis without increasing significant side effects.