Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
In Vivo. 2020 Nov-Dec;34(6):3399-3406. doi: 10.21873/invivo.12178.
BACKGROUND/AIM: The impact of diverting ileostomy on the feasibility of adjuvant chemotherapy (ACT) remains unclear. We retrospectively investigated the tolerability and adverse events of ACT for rectal cancer in patients with diverting ileostomy.
Thirty-three patients who received ACT after curative resection with ileostomy construction for rectal cancer were analyzed. We assessed completion rate, the mean relative dose intensities, and the factors affecting the tolerability of ACT.
The completion rate of each chemotherapy regimen was 10 out of 16 patients in oral uracil-tegafur plus leucovorin (UFT/LV), 1 out of 3 patients in oral capecitabine (Capecitabine) and 2 out of 14 patients in capecitabine plus oxaliplatin (CAPOX). The mean relative dose intensities were 77% in UFT/LV, 48% in Capecitabine, and 57% of capecitabine and 42% of oxaliplatin in CAPOX. In multivariate analysis, laparoscopic surgery (Odds ratio=11.6, p=0.021) and receiving preoperative chemoradiotherapy (Odds ratio=32.4, p=0.021) were associated with treatment completion.
Completion rate of ACT in patients with diverting ileostomy was lower than that of colorectal cancer patients in the previous studies. UFT/LV may be a more tolerable regimen than Capecitabine or CAPOX in colorectal cancer patients with diverting ileostomy.
背景/目的：预防性回肠造口术对辅助化疗（ACT）可行性的影响尚不清楚。我们回顾性研究了预防性回肠造口术的直肠癌患者接受 ACT 的耐受性和不良反应。
分析了 33 例接受 ACT 的患者，这些患者在接受根治性切除术并建立预防性回肠造口术后接受了 ACT。我们评估了 ACT 的完成率、平均相对剂量强度以及影响 ACT 耐受性的因素。
在接受 UFT/LV、卡培他滨（Capecitabine）和 CAPOX 方案治疗的患者中，每种化疗方案的完成率分别为 16 例中的 10 例、3 例中的 1 例和 14 例中的 2 例。UFT/LV 的平均相对剂量强度为 77%，Capecitabine 为 48%，CAPOX 中的卡培他滨和奥沙利铂分别为 57%和 42%。多因素分析显示，腹腔镜手术（优势比=11.6，p=0.021）和术前放化疗（优势比=32.4，p=0.021）与治疗完成相关。
预防性回肠造口术患者 ACT 的完成率低于先前研究中结直肠癌患者的完成率。在预防性回肠造口术的结直肠癌患者中，UFT/LV 可能比 Capecitabine 或 CAPOX 更耐受。
