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Ⅱ/Ⅲ Rectal Cancer with Capecitabine Plus Oxaliplatin and Capecitabine Chemoradiotherapy Comparative Efficacy

Author: LiHongYan
Tutor: JiaZuoHui
School: Dalian Medical University
Course: Oncology
Keywords: colorectal cancer preoperative chemoradiation capecitabine oxaliplatin
CLC: R735.37
Type: Master's thesis
Year: 2013
Downloads: 22
Quote: 0
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Abstract


Objective:colorectal cancer is one of the most common causes of death inmalignant tumor, surgical operation treatment is an important treatment method forrectal cancer, but II/III rectal cancer after operation simple, local recurrence rate ashigh as20%-65%, serious impact on the long-term survival rate. Adjuvant therapy forrectal cancer including preoperative and postoperative adjuvant therapy. Recentresearch results show that, with the help of preoperative neoadjuvant chemotherapy canimprove the local control of locally advanced low rectal cancer rate and the rate of analpreservation, is a new trend in the adjuvant treatment of rectal cancer. With a long-termfollow-up study of a large multicenter results were published, the curative effect ofneoadjuvant therapy further recognized. Gradually become the standard scheme ofcomprehensive treatment for rectal cancer. This experiment mainly study II/III rectalcancer with capecitabine plus oxaliplatin and capecitabine chemoradiotherapy curativeeffect and adverse reaction of contrast comparison.Method:our hospital from2011.6-2012.12were II/III rectal cancer patients wereprospectively studied, including70cases of rectal cancer patients were included in thestudy, were randomly divided into capecitabine plus oxaliplatin and radiotherapy group(treatment group) and capecitabine and radiotherapy group (control group).Capecitabine usage was1600mg/m (2)/day,2times/day, oral, respectively d22-35orally in d1-14days and radiotherapy. Oxaliplatin usage was80mg/m (2)/day,1times/day, intravenous infusion, were given in first,8,22in radiotherapy,29days. The twogroups were treated with three-dimensional conformal radiotherapy, radiotherapy dosewas50Gy/25f irradiation, conventional segmentation,2Gy/f,5f/W,10MV were used toX-ray linear accelerator treatment. To observe the efficacy and toxicity of6weeks afterthe end of treatment of pelvic CT. Results:the near future curative effect from the start of treatment to the end oftreatment6weeks after the comprehensive review. Efficient RR treatment group andthe control group (CR+PR) were60%(21/35),42.85%(15/35), no significantdifference (2=2.21, P>0.05). The treatment group and the control group of diseasecontrol rate of DCR (CR+PR+SD) were82.86%(29/35),82.85%(29/35), the twogroups had no statistical significance (P>0.05). Experiments show that the treatmentgroup received capecitabine plus oxaliplatin and radiotherapy, the control groupreceived capecitabine and radiotherapy group in the total efficiency of two recent RR,disease control rate (CR+PR+SD DCR) and no statistic significance. The degree ofadverse reactions of two groups of patients with WHO classification standard. Adversereactions in treatment group include blood toxicity and gastrointestinal tract reaction,mostly Ⅰ/Ⅱ, Ⅲgrade rare adverse reactions. The treatment group of hematologicaltoxicity include leukopenia, neutropenia, non-hematologic toxicity reactions werediarrhea and fatigue. The treatment group and the control group, the decrease of whiteblood cells was respectively82.9%,57.1%, there was significant difference betweentwo groups (2=5.51, P<0.05). The treatment group and the control group ofneutropenia incidence rates were80%,54.3%, there was significant difference betweentwo groups (2=5.24, P<0.05). The treatment group and the control group the incidenceof diarrhea were97.1%,82.9%, there was significant difference between two groups (2=3.97, P<0.05). Other adverse effects were no significant difference between the twogroups. Nausea, vomiting and other symptoms are relatively light, the patient cantolerate. In this study, the treatment group more than grade hematologic adversereactions were neutropenia occurred in2cases (5.7%), anemia occurred in2cases(5.7%), the control group did not occur more than grade hematologic adverse reaction;treatment of grade III non-hematologic toxicities were diarrhea in1cases (2.9%). Thecontrol group did not appear more than grade adverse reaction. Although the two groupsof capecitabine and oxaliplatin and radiotherapy group more than grade adverse reactionrate is slightly higher, but the difference was not statistically significant, aftersymptomatic treatment can alleviate, the patient can tolerate. The experimentaltreatment group, control group1cases of hand-foot syndrome. The treatment group hadneurotoxicity in2cases, symptoms are relatively light. Event treatment-related deathswere not found in two groups of patients.Conclusion:The treatment group of capecitabine and oxaliplatin concurrentthree-dimensional conformal radiotherapy and the control group of capecitabine and concurrent three-dimensional conformal radiotherapy compared, no significantdifference with efficiency in the near future, disease control rate. Treatment group wasslightly heavier than the control group of patients with adverse reactions, but aftersymptomatic treatment can be tolerated. Both the treatment of preoperative II/III rectalcancer curative effect, can cause tumors to shrink, reach the tumor downstaging. But thelong-term effects such as anal sphincter preservation rate, local control rate for furtherfollow-up study. Experimental results show that, capecitabine plus oxaliplatin combinedwith three-dimensional conformal radiotherapy is a promising treatment method, safeand reliable, can be used as a preoperative II/III rectal cancer of neoadjuvant therapyscheme. In the near future curative effect on the experimental results and a large numberof domestic and foreign research results, the treatment group with capecitabine plusoxaliplatin and radiotherapy group and the control group of capecitabine andradiotherapy group differences in efficacy and no statistic significance.But the number of the data sample is very little, may cause the results appeardeviation, this is the inadequacy of this study. The treatment group of capecitabine plusoxaliplatin and radiotherapy group and the control group with capecitabine andradiotherapy card comparison group in the long-term effect remains to be furtherfollow-up study.

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CLC: > Medicine, health > Oncology > Gastrointestinal Cancer > Intestinal neoplasms > Rectal cancer
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