Preliminary study for neoadjuvant chemotherapy on locally advanced rectal cancer
10.3760/cma.j.cn113855-20200227-00132
- VernacularTitle:新辅助化疗在局部进展期直肠癌中的应用效果
- Author:
Yingbin WANG
1
;
Xingwei XU
;
Quan SHAO
;
Bin LI
;
Yingkai WANG
;
Pengming WEI
Author Information
1. 太原钢铁（集团）有限公司总医院（山西医科大学第六医院）胃肠外科 030003
- From:
Chinese Journal of General Surgery
2020;35(10):768-772
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effect of neoadjuvant chemotherapy on locally advanced rectal cancer.Methods:After collecting the clinical data of 180 rectal cancer patients diagnosed initially as cT3-4N0-2M0 stage, patients were divided into neoadjuvant chemotherapy group, neoadjuvant chemoradiotherapy group and control group. First-line chemotherapy regimen CAPEOX was used as neoadjuvant therapy. Second-line chemotherapy regimen FOLFIRI was used for the patients not sensitive to CAPEOX . Long-term radiotherapy (total dosage: 45-50 Gy)was used in the neoadjuvant chemoradiotherapy group. The compliance, anastomotic fistula , infection and incidence of anal dysfunction, effective rate of neoadjuvant therapy and tumor reduction rate were observed.Results:The compliance of neoadjuvant treatment was higher than that of the control group(90% vs.85% vs.73%, χ 2=6.16, P<0.05); The rate of adverse reaction in neoadjuvant chemoradiotherapy group was higher than that in the neoadjuvant chemotherapy group and control group(28% vs.6% vs.12%, χ 2=10.57, P<0.05); The anastomotic fistula(17% vs. 6% vs. 5%, χ 2=6.95, P<0.05), infection rate(16% vs. 5% vs. 3%, χ 2=6.89, P<0.05)and incidence of anal dysfunction(21% vs. 9% vs.7%, χ 2=6.42, P<0.05) in neoadjuvant chemoradiotherapy group were higher than that in the neoadjuvant chemotherapy group and control group. There was no significant difference between the neoadjuvant chemotherapy group and the control group( P>0.05) .Overall effective rate in neoadjuvant chemotherapy group and neoadjuvant chemoradiotherapy group was 40 % and 66%, respectively. Conclusions:Patients with locally advanced rectal cancer have better compliance with neoadjuvant chemotherapy and lower toxic side effects compared to neoadjuvant chemoradiotherapy. Neoadjuvant chemotherapy can be safely and effectively used in locally advanced rectal cancer.
