CapeOx In Preoperative Concurrent Chemoradiotherapy For Locally Advanced Rectal Cancer Compared The Efficacy And Adverse Reactions Of Xeloda

Objective:In recent years,with the wide application of neoadjuvant therapy and the continuous improvement of radical surgery,the treatment and prognosis of locally advanced middle and low rectal cancer have made great progress,and the overall survival and local recurrence rate have been significantly improved.According to the regulations of the ministry of health for the diagnosis and treatment of colorectal cancer in China and the guidelines for the diagnosis and treatment of colorectal cancer in NCCN and ESMO,it is pointed out that patients with locally advanced colorectal cancer should first receive neoadjuvant chemoradiotherapy,and complete mesorectal resection should be performed after 5-12 weeks.For patients with middle and low rectal cancer,especially low rectal cancer,in order to achieve RO resection,the tumor and anus have to be combined resection,permanent colostomy on the abdominal wall,which makes the psychological and physiological functions of patients are seriously affected.Individual differences exist in tumor regression of rectal cancer patients after neoadjuvant therapy.It is reported that about 20-30%of patients could achieve clinical complete remission,10-20%of patients can achieve pathological complete remission,most patients have partial clinical remission,but a small number of patients still have no remission or progress[6].The purpose of this study was to analyze the different efficacy and adverse reactions of neoadjuvant chemoradiotherapy in patients with locally advanced stage low rectal cancer.Methods:Randomly selected from 2015 January 1 to December 31,2015,in yunnan province tumor hospital for medical treatment in colorectal surgery by MRI,rectal cavity ultrasound,colonoscopy and diagnosed with locally advanced disease check the mid-term low rectal cancer patients under the age of 75,including 41 routine CapeOx neoadjuvant chemotherapy,39 routine Xeloda neoadjuvant chemotherapy,has 50.4 Gy/25 f/1.8 2.0 Gy intensity-modulated radiotherapy,treat tumor regression after total mesorectum excision surgery.The efficacy of radiotherapy and chemotherapy was evaluated in both groups,including tumor regression,anal retention rate,recurrence and metastasis rate,adverse reactions to radiotherapy and chemotherapy,and short-term survival rate(3-year DFS).Results:1.In CapeOx group,the decline rate was 76.9%,and the distant metastasis rate was 15.4%;In the Xeloda group,the downstaging rate was 58.5%and the distant metastasis rate was 34.1%.P<0.05,with statistical difference.2.Adverse reactions were divided into hematopenia,gastrointestinal reaction,hand and foot syndrome and peripheral neuropathy,all with P<0.05,showing statistical difference.3.There was no significant correlation between concurrent chemoradiotherapy and three-year disease-free survival in the two groups(P=0.581),with no statistical difference.4.EMVI,tumor location,tumor circumference length,and PCR after chemoradiotherapy were significantly correlated with the three-year disease-free survival of patients with rectal cancer(P<0.05,with statistical difference).Conclusions:After neoadjuvant chemoradiotherapy,there were differences in tumor remission,recurrence and metastasis rates between the two groups,but no difference in disease-free survival.Grade 3-4 adverse reactions of myelosuppression were more severe in CapeOx group than in Xeloda group.