Study On The Security Of Early Postoperative Adjuvant Chemotherapy With XELOX Regimen In Patients With Colorectal Cancer After Enhanced Recovery After Surgery

Purpose:Surgical excision is not effective in the treatment of colorectal cancer.Tumor cells remain in the body through micrometastasis of blood.At present,radical resection combined with postoperative adjuvant chemotherapy is the most effective treatment for colorectal cancer.Extensive consensus has been reached on the scope of radical resection and the number of lymph node dissection.There is still no uniform conclusion as to when adjuvant chemotherapy should begin after operation.Several studies have shown that the earlier adjuvant chemotherapy begins,the better the treatment of cancer is.However,the practical clinical practice of early chemotherapy is more concerned.In order to ensure wound healing,physical recovery and safety of intestinal anastomosis,the current clinical practice is to start the first postoperative adjuvant chemotherapy 3 to 4 weeks after operation.At the same time,the application of accelerated rehabilitation surgery in the field of colorectal surgery in recent years has proved that patients can recover more quickly and reduce the postoperative hospitalization time.By using the idea of laparoscopic minimally invasive surgery and accelerated rehabilitation surgery,the patients can get better recovery in 2 weeks after operation.The purpose of this experiment is to explore the security and feasibility of XELOX adjuvant chemotherapy for patients with colorectal cancer(within 2 weeks after surgery)on the basis of enhanced recovery after surgery.Methods:From January 2016 to December 2017,60 patients with colorectal cancer diagnosed as high risk stage ? and ? were selected from gastrointestinal surgery department of PLA 101 hospitals to be included in the experimental sample.All patients were randomly divided into two groups for a controlled study.25 of them started adjuvant chemotherapy within 2 weeks after operation.The other 35 cases started adjuvant chemotherapy about 4 weeks after operation.Conducted a controlled study between the two groups.The perioperative management of the two groups was performed according to the requirements of the enhanced recovery after surgery program(2015 edition of the Chinese expert consensus on the application of accelerated rehabilitation surgery for colorectal surgery).Both groups were treated with oxaliplatin combined with Capecitabine Tablets(XELOX)for three weeks.The postoperative condition,complication rate,completion rate of adjuvant chemotherapy and adverse reaction of chemotherapy were observed through the two groups.Post-operative conditions include time for postoperative recovery of exhaust,time for postoperative recovery of defecation,time to recovery of hemifluid diet after operation,time to stop rehydration after operation and Postoperative hospitalization days.Adverse reactions after first chemotherapy include peripheral neurotoxicity,nausea and vomiting,diarrhea and bone marrow depression.Results:There was no significant difference between the two groups under the basic circumstances(P>0.05).There were no deaths,anastomotic leakage and abdominal infection during the operation and adjuvant chemotherapy in the two groups.There was no significant difference between the two groups of postoperative hospitalization,postoperative gastrointestinal recovery,and defecation time(P>0.05).The adverse reactions of adjuvant chemotherapy in the early chemotherapy group and the control group were not statistically significant(P>0.05).Conclusion:Through the application of the concept of Enhanced Recovery After Surgery,patients with colorectal cancer can shorten the time required for postoperative recovery of anal exhaust and defecation,reduce postoperative hospital stay,and allow patients to be discharged as soon as possible.Early adjuvant chemotherapy 2weeks after operation did not increase the incidence of complications after radical resection of colorectal cancer,nor did it lead to the aggravation of adverse effects of chemotherapy.Based on the application of Enhanced Recovery After Surgery,adjuvant chemotherapy with XELOX regimen is safe and feasible for early postoperative colorectal cancer.