Research Of Changaikangfu Decoction Combined With Neoadjuvant Chemotherapy In Low Rectal Cancer Before Surgery

ObjectiveBy evaluating tumor remission, patients generally functional status improvement, chemotherapy-induced toxicities and the rate of Sphincter preservation, postoperative complications such as anastomotic leakage with Changaikangfu decoction combined with neoadjuvant chemotherapy and preoperative neoadjuvant chemotherapy alone.Discussion the advantages and role of Chinese traditional medicine combined with neoadjuvant chemotherapy in colorectal cancer before low sphincter preserving surgery applications.MethodsA prospective randomized controlled study, hospitalized patients25cases of low rectal cancer in the First Affiliated Hospital of Guangxi Medical University from2012.10to2013.4and hospitalized patients15cases of low rectal cancer in Guang’anmen Hospital, China Academy of Chinese medical Sciences from2012.1to2014.2are screened.They are randomly divided into two groups, one group undergoes operation treatment directly after preoperative neoadjuvant chemotherapy after3cycles, the other group on the basis of neoadjuvant chemotherapy combined with changaikangfu decoction after3cycles undergoes operation treatment too. Comparison between the two groups in the tumor remission after treatment, improvement of the general condition of the patient, changes in carcinoembryonic antigen, toxicity of neoadjuvant chemotherapy induced and the rate of sphincter preservation, postoperative complications and so on. All data are statistically analyzed using spss18.0, two-sided test. The measurement data of each group before and after treatment use mean±standard deviation to describe, count data using the constituent ratio of description. P<0.05indicates significant difference.Results(1) Improvement in quality of life, the two groups have statistical significance, namely P=0.024<0.05, traditional Chinese medicine combined with neoadjuvant chemotherapy on patients quality of life improvement is better than the simple neoadjuvant chemotherapy group.(2) The aspect of tumor size changes, the two groups have statistical significance, namely P=0.048<0.05, traditional Chinese medicine combined with neoadjuvant chemotherapy in the treatment of the tumor volume to decrease is significantly better than the simple neoadjuvant chemotherapy group.(3) Carcinoembryonic antigen changes before and after neoadjuvant chemotherapy combined with traditional Chinese medicine have significant difference, namely P=0.0029<0.05(before treatment is11.073±8.975and after treatment is4.114±2.324); before and after neoadjuvant chemotherapy alone have significant difference, namely P=0.003<0.05(before treatment is10.606±6.402and after treatment is5.102±4.412), that is, the carcinoembryonic antigen in two groups after the treatment are significantly decreased. But comparing with the two groups after treatment, P=0.3829>0.05, there are no significant difference. The results indicate that joining or not of traditional Chinese medicine has no significant effect on CEA drop.(4) Occurrence of the adverse effects after chemotherapy, neoadjuvant chemotherapy combined with traditional Chinese medicine in improving appetite, reducing nausea and vomiting, reducing diarrhea and constipation and other complications caused by chemotherapy are better than the group of neoadjuvant chemotherapy alone. But in the upper limb numbness caused by chemotherapy, two groups have no significant difference. The aspects of hematological toxicity, white blood cells and platelets in the group of neoadjuvant chemotherapy alone after treatment are significantly decreased compared with those before treatment (P<0.05), alanine aminotransferase and aspartate aminotransferase are significantly increased compared with those before treatment (P<0.05), red blood cells does not change significantly before and after the treatment. In the group of traditional Chinese medicine combined with neoadjuvant chemotherapy after treatment in terms of white blood cells,red blood cells, platelets, alanine aminotransferase and aspartate aminotransferase compared with those before treatment are no significant difference in change (P>0.05). (5) Comparison of operation mode,4cases in the group of traditional Chinese medicine combined with chemotherapy are treated with Dixon, intersphincteric operation in4cases, with Peranal pull through anastomosis in8cases,4cases in Miles, the rate of sphincter preservation is80%.2cases in the group of neoadjuvant chemotherapy alone undergo Dixon, intersphincteric operation in6cases, with Peranal pull through anastomosis in3cases,9cases in Miles, the rate of anal sphincter preservation is55%. The rate of sphincter preservation in both groups, P=0.176>0.05, has no significant differences.(6) The aspects of perioperative complications, the group of traditional Chinese medicine combined with neoadjuvant chemotherapy have one case of anastomotic leakage, one case of anastomotic stenosis and without perineal infection, the rate of postoperative complication is10%. The group of neoadjuvant chemotherapy alone have three cases of anastomotic leakage, one case of anastomotic stenosis and one case of perineal infection, the rate of postoperative complication is25%. The rate of postoperative complication in both groups, P=0.646>0.05, has no significant differences.ConclusionApplication of changaikangfu decoction combined with neoadjuvant chemotherapy in low rectal cancer patients before surgery, it can not only reduce tumor burden effectively, reduce the CEA, but also improve the functional status of patients, alleviate neoadjuvant chemotherapy-induced toxicity and improve the patient tolerance of surgery.