3种新辅助治疗方案治疗中低位直肠癌的围手术期安全性评价

来源 :中国普外基础与临床杂志 | 被引量 : 0次 | 上传用户:zyq201314
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目的比较标准新辅助放化疗(neoadjuvant long-course chemoradiotherapy.CRT)、短程新辅助放疗(neoadjuvant short-course radiotherapy.SCRT)及全程新辅助放化疗(total neoadjuvant treatment.TNT)3种方案的放化疗卡相关并发症和围手术期安全性。方法回顾性分析华西医院J2014年7)月至2016年2月期间收治的63例接受了术前新辅助治,疗的中低位直肠癌患者的临床资料,根据新辅助放化疗方案将患者分CRT组15例、SCRT组30例和TNT组18例,比较3组患者的放化疗卡相关并发症发生情况和围手术期安全性指标。结果①放化疗相关并发症:63例患者中发生放化疗相关并发症29例,总放化疗相关并发症发生率为46.0%.,其中包括放射性肠炎9例和骨髓抑制25例3组患者的总放化疗卡相关并发症发生率、放射一性肠炎发生率和骨髓抑制发生率均不同(PS0.001),SCRT组的总放化疗相关并发症发,生率和放射性肠炎发生率较低。②围手术期安全中性指标:3组患者的总手术并发症发生率、各具体并发症发生率、手术持续时间、术中出血量及术后肛门首次排气时间比较差异均无统汁学意义(P<0.05),但3组的术后住院时间不同,SCRT组较短(P=0.033)。结论 3种放化疗力方案的围手术期安全性指标总体无明显差异,但SCRT的住院时间略短,提示SCRT值得进一步研究推广。 Objective To compare radiotherapy and chemotherapy with standard neoadjuvant chemotherapy (CRT), neoadjuvant short-course radiotherapy (SCRT) and total neoadjuvant chemotherapy (TNT). Related complications and perioperative safety. Methods A retrospective review was performed on the clinical data of 63 patients with moderate to low rectal cancer who were treated with preoperative neoadjuvant treatment from July 2014 to February 2016 in West China Hospital. The patients were divided into CRTs according to the neoadjuvant radiochemotherapy protocol. Fifteen patients in the group, 30 patients in the SCTR group, and 18 patients in the TNT group were compared for the complications of chemoradiotherapy and perioperative safety in the three groups. Results 1 Radiochemotherapy-related complications: Chemotherapy and chemotherapy-related complications occurred in 63 cases, and the incidence of total complications related to radiochemotherapy was 46.0%. Among them, 9 cases of radiation enteritis and 25 cases of bone marrow suppression were included in the 3 groups. The incidence of complication-related complications, incidence of radiation-associated enteritis, and myelosuppression were all different (PS0.001). The complications associated with total radiochemotherapy in the SCRT group were lower, and the incidence of birth rate and radiation-induced enteritis was lower. 2 Neutral indicators of perioperative safety: There were no differences in the incidence of total surgical complications, the incidence of specific complications, the duration of surgery, the amount of intraoperative blood loss, and the time for first postoperative anal exhaustion in all three groups. Significance (P < 0.05), but the postoperative hospital stay was different in the 3 groups, and the SCRT group was shorter (P = 0.033). Conclusion There are no significant differences in the perioperative safety indicators of the three radiochemotherapy regimens, but the hospitalization time of SCRT is slightly shorter, suggesting that SCRT is worthy of further research and promotion.
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