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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。
Objective To investigate the efficacy and adverse reactions of FOLFOX 4 combined with radiotherapy in the treatment of locally advanced unresectable rectal cancer. Methods Forty-three patients with locally advanced rectal cancer were treated in Fuyang People’s Hospital from June 2011 to June 2012. They were randomly divided into two groups: 22 cases in the treatment group and 21 cases in the control group. The two groups were treated with FOLFOX 4 regimen. The treatment group Radiotherapy combined. Observed for 3 months after the end of treatment, the CT examination of the lesion site to evaluate the short-term efficacy, the use of EORTC-QLQ-CR29 scale to evaluate the quality of life of patients. Results The effective rate of the treatment group was higher than that of the control group (P = 0.023). The disease control rate was 86.36%, which was higher than that of the control group (42.86%). Compared with the control group, patients with chemotherapy combined with radiotherapy had an alleviated anxiety (P = 0.015), a certain improvement in the symptoms of defecation incontinence (P = 0.044), and a certain degree of relief of dry mouth symptoms (P = 0.009) Statistical significance. But had no significant effect on body size and body weight in functional dimension (P> 0.05). In frequent urination, blood and mucus in stool, frequent bowel movements, dysuria, abdominal pain, hip pain, abdominal distension, hair loss, Flatulence, defecation incontinence, fistula care problems, perianal skin pain, defecation embarrassment and other symptoms, the difference was not statistically different (P> 0.05). After 20 months, the survival rate of the treatment group was 77.27%, while the control group was 61.9%. Conclusions For patients with locally advanced geriatric rectal cancer, concurrent chemotherapy with radiotherapy is the best treatment for improving disease control rate, quality of life and prolonging life expectancy.