摘要
目的观察西黄丸加减联合新辅助放化疗治疗局部晚期直肠癌的疗效及安全性。方法选择2010年9月~2021年4月广东药科大学附属第一医院和南方医科大学珠江医院就诊的95例中低位局部进展期直肠癌患者,分为治疗组(48例)和对照组(47例)。对照组行新辅助放化疗,治疗组在对照组基础上加用西黄丸加减,观察比较两组治疗病理完全缓解率、肿瘤降期率、局部复发率、远处转移率及毒副作用。结果所有患者均接受新辅助放化疗,6~10周后行根治性手术,治疗组中1例患者因新辅助放化疗后获得完全缓解未行手术。治疗组病理完全缓解率为29.2%、肿瘤降期率为60.4%,对照组病理完全缓解率为14.9%、肿瘤降期率为46.8%,均高于对照组,但两组间肿瘤缓解程度差异无统计学意义(P>0.05)。放化疗相关血液学毒副反应中,治疗组和对照组白细胞减少发生率分别为35.5%和40.5%,粒细胞减少发生率分别为50.0%和40.4%,血红蛋白减少发生率分别为70.8%和72.4%,血小板减少发生率分别为29.2%和29.8%;非血液学不良反应中,治疗组和对照组放射性肠炎的发生率分别为22.9%和21.3%,肝功能损害发生率分别为37.5%和36.2%,肾功能损害发生率分别为16.7%和8.5%,两组不良反应发生率差异无统计学意义(P>0.05)。两组患者局部复发率差异无统计学意义(20.8%vs.21.3%);治疗组远处转移率为10.6%,低于对照组的23.4%,差异无统计学意义(P>0.05)。另外,两组患者的保肛率差异无统计学意义(54.2%vs.59.6%,P>0.05)。结论西黄丸加减联合新辅助放化疗在局部进展期直肠癌中有提高肿瘤缓解的趋势,具有降低肿瘤的远处转移的潜力,而不增加放化疗的毒副作用及肿瘤手术切除的难度。
OBJECTIVE To observe the efficacy and safety of Xihuang pills combined with neoadjuvant chemoradiotherapy in locally advanced rectal cancer.METHODS 95 patients with locally advanced rectal cancer in the First Affiliated Hospital of Guangdong Pharmaceutical University and Zhujiang Hospital of Southern Medical University were selected and divided into treatment group(48 cases)and control group(47 cases)from September 2010 to April 2021.The control group received neoadjuvant chemoradiotherapy,and the treatment group was treated with chemoradiotherapy combined with Xihuang pills.The pathological complete response rate,tumor descent rate,local recurrence rate,distant metastasis rate and toxic and side effects were observed and compared between the two groups.RESULTS All patients received neoadjuvant chemoradiotherapy,and radical surgeries were performed 6-10 weeks later.One patient in the treatment group did not receive surgery because of complete remission after neoadjuvant chemoradiotherapy.The pathological complete response rate and the tumor descending stage rate of the treatment group was 29.2%and 60.4%vs.14.9%and 46.8%in the control group(P>0.05).The incidence of leucopenia,granulocyte reduction,hemoglobin reduction and thrombocytopenia in the treatment group and the control group were 35.5%vs.40.5%,50.0%vs.40.4%,70.8 vs.72.4%,29.2%vs.29.8%,respectively(P>0.05).The incidence of radiation enteritis in the treatment group and the control group was 22.9%and 21.3%,the incidence of liver function damage was 37.5%and 36.2%,and the incidence of renal function damage was 8.5%and 16.7%,respectively.There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).There was no significant difference in local recurrence rate between the two groups(20.8%vs.21.3%).The rate of distant metastasis in the treatment group was 10.6%,lower than that in the control group(P>0.05).In addition,there was no significant difference in the anal retention rate between the two groups(54.2%vs.59.6%,P>0.05).CONCLUSION Xihuang pills combined with neoadjuvant chemoradiotherapy has a tendency to improve tumor remission in locally advanced rectal cancer,and can reduce the distant metastasis of tumor,without increasing the side effects of chemoradiotherapy and the difficulty of surgical resection.
作者
舒阳春
李丽琳
王端玉
李纪强
SHU Yangchun;LI Lilin;WANG Duanyu;LI Jiqiang(The First Affiliated Hospital of Guangdong Pharmaceutical University,Guangzhou,Guangdong 510699,China;Zhujiang Hospital of Southern Medical University,Guangzhou,Guangdong 510282,China)
出处
《今日药学》
CAS
2022年第9期702-707,共6页
Pharmacy Today
基金
国家自然科学基金青年项目(81503526)
广东省自然基金项目(2015A030310448)
关键词
局部晚期直肠癌
新辅助放化疗
病理完全缓解
肿瘤降期
西黄丸
locally advanced rectal cancer
neoadjuvant chemoradiotherapy
pathological complete response
tumor descending stage rate
Xihuang pills
作者简介
舒阳春,副主任医师,研究方向:消化道肿瘤临床和基础研究;通信作者:李纪强,副主任医师,研究方向:消化道肿瘤临床和基础研究,E-mail:ljq821028@126.com
