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新辅助化疗联合腹腔镜手术治疗中低位直肠癌的临床疗效及其对血清VEGF水平和生活质量的影响

Clinical efficacy of Neoadjuvant Chemotherapy combined with Laparoscopic Surgery in patients with Middle and Low Rectal Cancer and its Effect on serum VEGF Levels and quality of life.

作者信息

Hou Wei, Song Xin, Pan Qingfang, Liu Sukun, Zhao Qinglian, Hong Dan

机构信息

Wei Hou, Department of Radiotherapy, Baoding NO.1 Central Hospital, Baoding 071000, Hebei, China.

Xin Song Endoscopy Room, Baoding Dawu Hospital, Baoding 072550, Hebei, China.

出版信息

Pak J Med Sci. 2023 Nov-Dec;39(6):1568-1572. doi: 10.12669/pjms.39.6.6763.

Abstract

OBJECTIVE

To observe the clinical efficacy of neoadjuvant chemotherapy combined with laparoscopic surgery in patients with middle and low rectal cancer and its effect on serum VEGF level and quality of life.

METHODS

Retrospective analysis was performed on 80 patients with middle and low rectal cancer admitted to Baoding No.1 Central Hospital from June 2018 to June 2020.They were randomly divided into two groups. Patients in the control group underwent laparoscopic radical rectal cancer surgery, while those in the experimental group underwent neoadjuvant chemotherapy before surgery. The differences of various surgical indicators between the two groups were compared. The incidence of surgical complications, the serum VEGF levels and the improvement of quality of life were compared. The differences in local recurrence, metastasis and overall survival with in two years after surgery were compared.

RESULTS

The various surgical indicators of the experimental group were significantly better than the control group (p<0.05). After treatment, the VEGF levels in the experimental group were significantly lower than those in the control group (p=0.00), while the SF-36 score was significantly higher than that of the control group (p=0.00). The total incidence of surgical complications in experimental group was significantly lower (p=0.03), the local recurrence rate was significantly lower (p=0.02), and the overall survival rate was significantly higher than that in control group (p=0.04).

CONCLUSION

Neoadjuvant chemotherapy combined with laparoscopic surgery is superior to direct surgery alone in the treatment of middle and low rectal cancer and it needs to be promoted.

摘要

目的

观察新辅助化疗联合腹腔镜手术治疗中低位直肠癌患者的临床疗效及其对血清血管内皮生长因子(VEGF)水平和生活质量的影响。

方法

回顾性分析2018年6月至2020年6月保定市第一中心医院收治的80例中低位直肠癌患者。将他们随机分为两组。对照组患者接受腹腔镜直肠癌根治术,而实验组患者在手术前行新辅助化疗。比较两组患者各项手术指标的差异。比较手术并发症的发生率、血清VEGF水平及生活质量的改善情况。比较两组患者术后两年内局部复发、转移及总生存率的差异。

结果

实验组各项手术指标明显优于对照组(p<0.05)。治疗后,实验组VEGF水平明显低于对照组(p=0.00),而简明健康状况调查量表(SF-36)评分明显高于对照组(p=0.00)。实验组手术并发症总发生率明显较低(p=0.03),局部复发率明显较低(p=0.02),总生存率明显高于对照组(p=0.04)。

结论

新辅助化疗联合腹腔镜手术治疗中低位直肠癌优于单纯直接手术,值得推广。

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Low rectal cancer treatment strategies: a cohort study assessing watch and wait.低位直肠癌治疗策略:一项评估观察等待的队列研究。
J Cancer Res Clin Oncol. 2020 Oct;146(10):2631-2638. doi: 10.1007/s00432-020-03248-0. Epub 2020 May 20.

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