摘要目的 探讨奥沙利铂联合卡培他滨的术前同步放化疗对提高直肠癌局控率和保肛率的研究.方法 选择Ⅱ/Ⅲ期直肠腺癌患者80例,随机数字表法分为对照组和观察组,各40例.均行放疗,观察组采用奥沙利铂联合卡培他滨方案,对照组采用奥沙利铂联合亚叶酸钙联合5-氟尿嘧啶方案,2~4周后行手术治疗.比较两组患者的局部疗效,围手术期生化指标,R0(切缘无癌细胞)切除率及保肛率.结果 对照组近期疗效47.50%,观察组近期疗效为60.00%,观察组显著优于对照组,差异有统计学意义(x2=4.22,P<0.05).两组患者术前各项生化指标差异无统计学意义(P>0.05).对照组及观察组R0切除率分别为62.50%、57.50%,差异无统计学意义(x2=0.67,P>0.05),对照组及观察组的保肛率分别为32.50%、37.50%,差异无统计学意义(x2=0.67,P>0.05),对照组及观察组局控率分别为90.00%、92.50%,差异无统计学意义(x2=0.32,P>0.05),观察组虽高于对照组,但差异均无统计学意义.结论 奥沙利铂联合卡培他滨的术前同步放化疗对直肠癌患者可提高局部疗效,不影响围手术期患者生化指标,但对患者R0切除率及保肛率影响与FOLFOX4化疗方案对比差异不大,值得临床推广.

abstractsObjective To investigate the effect of oxaliplatin combined with capecitabine on the rate of local control and anal sphincter preservation of rectal cancer.Methods Eighty patients with stage Ⅱ/Ⅲ colorectal adenocarcinoma were randomly divided into control group and observation group,each group in 40cases.The patients in the observation group were treated with oxaliplatin and capecitabine.The control group was treated with oxaliplatin combined with leucovorin and 5-fluorouracil.The patients were followed up for 2~4 weeks.The local curative effect, perioperative biochemical index,R0 (excision margin without cancer cell) resection rate and sphincter preserving rate were compared between the two groups.Results In the control group, the short-term curative effect was 47.50%, which in the observation group was 60.00%, the difference was statistically significant (x2=4.22,P<0.05).There were no statistically significant differences in the biochemical indicators between the two groups (all P>0.05).The R0 resection rates of the control group and the observation group were 62.50%,57.50% (x2=0.67,P>0.05).The anal sphincter preservation rates of the control group and observation group were 32.50%,37.50% respectively (x2=0.67,P>0.05).The local control rates of the control group and observation group were 90.00%,92.50%,which of the observation group was higher than the control group, but the difference was not statistically significant(x2 =0.32,P>0.05).Conclusion The combination of oxaliplatin and capecitabine can improve the local curative effect in patients with rectal cancer without affecting the biochemical indicators of perioperative patients, but the effect of R0 resection rate and preserving anus rate in patients with rectal cancer compared with the chemotherapy regimen of FOLFOX4 has no significant difference, it is worthy of clinical promotion.