| Objective: To evaluate the efficacy and safety of neoadjuvant chemotherapy(NACT) combined with laparoscopic surgery in treating the colorectal cancer, andprovide clinical evidence for the treatment of colorectal cancer.Methods:78cases of colorectal cancer in First Hospital of Quanzhou cancertreatment center from July2009to Dec2010were involved in this retrospective study,including NACT and laparoscopic surgery group (n=37) and pure laparoscopic surgerygroup (n=41). NACT and laparoscopic surgery group have completed4cyclesFOLFOX4regimen before operation and the other8cycles after surgery. Laparoscopicgroup have accepted surgical treatment directly, and12cycles chemotherapy aftersurgery. The efficacy of NACT was observed. The chemotherapy side effects, radicalresection rate, operative time, blood loss in operation, postoperative exhaust time,postoperative feeding time, hospital stays and surgical complications were compared intwo groups. The accumulation of1year survival rate, progression-free survival, mediansurvival time and survival curves of the two groups were estimated by Kaplan-Meiermethod.Results: By CT examination, approximately43.2%patients had differentdiminution in the tumor diameter, and11patients with different clinical down stageafter NACT. The CEA and CA199negative rate in3months after the operation ofNACT and laparoscopic surgery group were significantly higher than pure laparoscopicsurgery group (P <0.05). With the corresponding symptomatic treatment, all patients could be tolerated the chemotherapy side effects. The chemotherapy side effects of thetwo groups were not significantly difference. The radical resection rate of NACT andlaparoscopic surgery group was94.6%, higher than the82.9%of the pure laparoscopicsurgery group. The operation time, postoperative activity time, postoperative feedingtime and operative complications had no significant difference. Compared with thelaparoscopic group, the progression-free survival of NACT and laparoscopic surgerygroup significantly increased (P=0.039). Their median survival time were (31.93±2.09) and (24.89±1.34) months respectively, and the accumulation of1year survivalrates were89.2%and82.9%respectively. The survival curves of the two groupsshowed the trend of separation, and their differences were statistically significant (X2=22.14, P <0.01).Conclusions: NACT and laparoscopic surgery for colorectal cancer patients is notonly good in safety and well tolerated, but also significantly prolongs PFS, MST andsurvival compared with the laparoscopic surgery group. |
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