【摘要】 目的观察术后不同化疗开始时间对进展期直肠癌根治术患者预后的影响。方法纳入本院2012年3月至2014年3月收治的70例接受腹腔镜直肠癌根治术的进展期直肠癌患者作为研究对象,随机抽签分为对照组和观察组,每组各35例。观察组在术后3 w内进行化疗治疗,对照组在术后3 w以后、8 w内进行化疗干预。比较两组患者术后Karnofsky(KPS)功能状态评分、化疗不良反应及化疗后3年生存率。结果两组化疗期间胃肠道反应、贫血、骨髓抑制、肝功能异常、胃溃疡及下肢静脉血栓等并发症发生率差异均无统计学意义(均P> 0.05)。观察组术后3年无进展生存率高于对照组(Log-rank χ~2=4.559,P=0.033),两组术后3年总生存率差异无统计学意义(Log-rank χ~2=0.447,P=0.504)。观察组出院1年和3年时KPS评分均高于对照组(均P <0.05)。结论进展期直肠癌根治术后患者在术后3 w内开始进行化疗有助于延长无进展生存时间,且术后身体功能状态好于较晚开始化疗的患者。更多还原

【Abstract】 Objectives To investigate the effect of timing of postoperative chemotherapy on prognosis of patients with advanced rectal cancer undergoing radical resection. Methods 70 patients with advanced rectal cancer treated in our hospital between March 2012 and March 2014 were recruited as study subjects. All patients received laparoscopic radical resection of rectal cancer. They were randomly assigned to control group and treatment group, with 35 patients in each groups. Patients in the treatment group received postoperative chemotherapy within 3 weeks after surgery and those in the control group received chemotherapy after 3 weeks but within 8 weeks. The followings were compared between the two groups: functional status measured by Karnofsky Performance Status(KPS) Scale, adverse reactions and 3-year survival after chemotherapy. Results There was no significant difference in incidence of adverse reactions, including gastrointestinal reactions, anemia, bone marrow suppression, abnormal liver function, gastric ulcer and lower limb deep vein thrombosis, between the two groups(P > 0.05). 3-year progression-free survival was significantly higher in the treatment group(Log-rank χ~2= 4.559, P = 0.033), but 3-year overall survival was similar between groups(Log-rank χ~2= 0.447, P = 0.504). KPS scores at 1 year and 3 years after discharge were significantly higher in the treatment group than in the control group(P < 0.05). Conclusion Initiating chemotherapy 3 weeks after surgery could improve progression-free survival in patients with advanced rectal cancer undergoing radical resection. It was also associated with a better postoperative functional status than initiating chemotherapy in a later stage.更多还原