术后早期化疗对III期结直肠癌患者临床预后的影响
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张静, Email: 00zhangjing01@sina.com

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Impact of early postoperative chemotherapy on the clinical outcomes in patients with stage III colorectal cancer
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    目的:探讨术后早期化疗对III期结直肠癌患者临床预后的影响。 方法:回顾性分析2010年1月—2014年2月收治的III期结直肠癌患者218例患者资料,根据术后化疗开始时间,将患者分为早期化疗组(化疗开始时间≤术后3周,118例)和晚期化疗组(化疗开始时间>术后3周、且≤8周,100例)。比较两组无进展生存期、2年生存率和复发率,以及化疗后不良反应与健康相关的生存质量。 结果:两组患者基础资料差异无统计学意义(均P>0.05);与晚期化疗组比较,早期化疗组无进展生存期明显延长(876.4 d vs. 765.4 d,P=0.007),2年生存率有所增高,但差异无统计学意义(89.0% vs. 80.0%,P=0.091),2年复发率明显降低(17.0% vs. 34.0%,P=0.004);化疗后各种不良反应发生率差异均无统计学意义(均P>0.05),术后12个月时健康相关的生存质量评分明显增高(71.9 vs. 64.1,P<0.001)。 结论:术后早期化疗能显著延长III期结直肠癌患者无进展生存期、降低复发率和改善健康相关的生存质量。

    Abstract:

    Objective: To investigate the impact of early postoperative chemotherapy on the clinical outcomes in patients with stage III colorectal cancer. Methods: The clinical data of 218 patients with stage III colorectal cancer treated from January 2010 to February 2014 were retrospectively analyzed. According to the time of initiation of chemotherapy, patients were divided into early chemotherapy group (started chemotherapy ≤3 weeks after surgery in 118 cases) or late chemotherapy group (started chemotherapy >3 weeks and ≤8 weeks after surgery in 100 cases). The variables that included progression-free survival, and 2-year survival and recurrence rate, as well as incidence of postchemotherapy adverse reactions and health-related quality of life score between the two groups were analyzed. Results: There was no difference in baseline data between the two groups (all P>0.05). In early chemotherapy group compared with late chemotherapy group, the progression-free survival time was significantly prolonged (876.4 d vs. 765.4 d, P=0.007), 2-year survival rate was somewhat elevated, but the difference reached no statistical significance (89.0% vs. 80.0%, P=0.091), 2-year recurrence rate was significantly reduced (17.0% vs. 34.0%, P=0.004), incidence of each postchemotherapy adverse reaction showed no statistical difference (all P>0.05), and the score for health-related quality of life at 12 months after surgery was significantly increased (71.9 vs. 64.1, P<0.001). Conclusion: For patients with stage III colorectal cancer, early postoperative chemotherapy can effectively prolong the progression-free survival, decrease recurrence and improve the health-related quality of life.

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张静,陆晔,崔新华,贾志强,邰小华.术后早期化疗对III期结直肠癌患者临床预后的影响[J].中国普通外科杂志,2016,25(4):492-496.
DOI:10.3978/j. issn.1005-6947.2016.04.006

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  • 收稿日期:2016-01-07
  • 最后修改日期:2016-03-15
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  • 在线发布日期: 2016-04-15