FOLFOX 4方案联合放疗对老年局部晚期直肠癌患者的疗效评价

Effect of Chemotherapy Combined with Radiotherapy for Elderly Patients with Locally Advanced Colorectal Cancer

关键词:  放疗  FOLFOX 4  局部晚期直肠癌  老年

Key words:  radiotherapy  FOLFOX 4 chemotherapy  locally advanced colorectal cancer  elderly

摘要:

目的 探讨FOLFOX 4方案联合放疗治疗局部晚期不可切除直肠癌的治疗疗效及不良反应。方法 富阳市人民医院2011年6月—2012年6月收治43例局部晚期直肠癌患者，随机分为2组，治疗组22例，对照组21例，2组同时给予FOLFOX 4方案化疗，治疗组联合给予放疗。治疗结束后观察3个月，对病灶部位进行CT检查以评价近期疗效，采用EORTC-QLQ-CR29量表评价患者生活质量。结果 治疗组有效率高于对照组(P=0.023)，疾病控制率为86.36%，高于对照组的42.86%。与对照组相比，化疗联合放疗患者焦虑有所缓解(P=0.015)，排便失禁的症状有一定改善(P=0.044)，口干的症状能一定程度上缓解(P=0.009)，差异有统计学意义。但在功能维度的体型和体质量方面无明显影响(P>0.05)，在排尿频繁、大便中的血及黏液、排便频繁、排尿困难、腹痛、臀痛、腹胀、掉发、味觉异常、胃肠胀气、排便失禁、造瘘照顾问题、肛周皮肤痛、排便尴尬等症状的比较中，差异无统计学差异(P>0.05)。20个月后，治疗组生存率为77.27%，而对照组为61.9%。结论 对于局部晚期的老年直肠癌患者，给予放射治疗同步化疗是提高疾病控制率和患者生活质量、延长寿命的最佳治疗方案。

Abstract:

OBJECTIVE To investigate efficacy and adverse reactions of FOLFOX 4 chemotherapy combined with radiotherapy for elderly patients with locally advanced colorectal cancer. METHODS From Jun 2011 to Jun 2012, 43 cases of locally advanced colorectal cancer were hospitalized and then randomly divided into two groups: 22 in the treatment group and 21 in the control group. Both two groups were given FOLFOX 4 chemotherapy, while the treatment group given radiotherapy at the same time. Then evaluated the short-term effect on the lesion site by CT and the quality of life of patients by EORTC-QLQ-CR29 scale after 3 months of treatment. RESULTS The efficient in treatment group was higher than that in control group(P=0.023), and disease control rate was 86.36% in treatment group, higher than 42.86% in control group. Compared with control group, patients with anxiety eased by chemotherapy with radiotherapy(P=0.015), bowel incontinence symptoms had some improvement(P=0.044), dry mouth symptom relieved(P=0.009), there were statistically significance. However, the figure in the functional dimensions and weight had no significant change(P>0.05). The symptom included frequent urination, blood in the stool and mucus, frequent bowel movements, difficulty urinating, abdominal pain, hip pain, bloating, hair loss, dysgeusia, flatulence, bowel incontinence, ostomy care of the problem, perianal skin pain and defecation embarrassment had no significant difference between two groups(P>0.05). After 20 months, survival rate of the treatment group was 77.27% while 61.9% in the control group. CONCLUSION For elderly patients with locally advanced colorectal cancer, radiotherapy with concurrent chemotherapy is the best therapy.