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目的:研究术后放化疗在高龄(≥75岁)III期直肠癌患者中的临床应用价值。方法:回顾性分析2010年1月—2014年1月收治的128例高龄(≥75岁)III期直肠癌患者资料,根据术后是否进行放化疗将患者分为放化疗组(60例)和对照组(68例),比较两组无进展生存期、2年存活率、健康相关的生存质量和术后主要并发症。结果:与对照组比较,放化疗组患者无进展生存期明显延长[(793.58±295.39)d vs.(736.59±305.38)d,P=0.029];2年存活率有增高趋势,但组间差异无统计学意义(91.7%vs.79.4%,P=0.052);术后12个月时健康相关的生存质量评分明显增高(70.25 vs.63.37,P<0.001);局部复发率明显降低(16.7%vs.33.8%,P=0.035);放射相关性肠炎(13.3%vs.0.0%)与骨髓抑制(11.7%vs.0.0%)发生率明显增高(P=0.002,P=0.004)。两组患者肠瘘、肠梗阻和贫血发生率均无统计学差异(均P>0.05)。结论:术后放化疗虽然增加了术后并发症的发生率,但是显著改善了高龄III期直肠癌患者长期预后。
Objective: To study the clinical value of postoperative chemoradiotherapy in elderly patients (≥75 years) with stage III rectal cancer. Methods: The data of 128 elderly patients (≥75 years) with stage III rectal cancer admitted from January 2010 to January 2014 were retrospectively analyzed. Patients were divided into radiotherapy and chemotherapy group (60 cases) and radiotherapy and chemotherapy group Control group (n = 68). Progression-free survival, 2-year survival, health-related quality of life and major complications were compared between the two groups. Results: Compared with the control group, progression-free survival was significantly prolonged in the radiochemotherapy group (793.58 ± 295.39 days vs. 736.59 ± 305.38 days, P = 0.029). The 2-year survival rate was increased, but the difference between the groups (91.7% vs.79.4%, P = 0.052). After 12 months, the health-related quality of life scores were significantly higher (70.25 vs.63.37, P <0.001); the local recurrence rate was significantly lower (16.7% vs.33.8%, P = 0.035). The incidence of radiation-related enteritis (13.3% vs.0.0%) and myelosuppression (11.7% vs.0.0%) were significantly higher (P = 0.002, P = 0.004). There was no significant difference in intestinal fistula, intestinal obstruction and anemia between the two groups (all P> 0.05). Conclusion: The postoperative radiotherapy and chemotherapy has increased the incidence of postoperative complications, but significantly improved the long-term prognosis of patients with advanced stage III rectal cancer.