Kết quả hóa trị bổ trợ sau hóa xạ trị tiền phẫu và phẫu thuật ung thư trực tràng giai đoạn cT3,4N1-2M0 tại Bệnh viện K=Results of adjuvant chemotherapy after preoperative chemoradiotherapy for stage cT3,4N1-2 of rectal cancer at K Hospital

0 Người đánh giá. Xếp hạng trung bình 0

Tác giả: Anh Tú Đỗ, Thị Luyến Nguyễn, Thị Thu Hường Nguyễn, Thắng Trần

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2024

Mô tả vật lý: tr.128-133

Bộ sưu tập: Metadata

ID: 252982

Thêm vào giỏ

Đánh giá thời gian sống thêm bệnh nhân ung thư trực tràng giai đoạn cT3,4N1-2M0 được hóa trị bổ trợ sau hóa xạ trị tiền phẫu và phẫu thuật ung thư trực tràng tại bệnh viện K và nhận xét một số tác dụng không mong muốn của phác đồ hóa chất bổ trợ sau phẫu thuật trên nhóm bệnh nhân nghiên cứu. Đối tượng và phương pháp nghiên cứu: Nghiên cứu mô tả hồi cứu trên 77 bệnh nhân ung thư trực tràng giai đoạn cT3,4N1-2M0 đã được hóa xạ trị đồng thời, sau đó được phẫu thuật triệt căn tại bệnh viện K từ tháng 01/2017 đến tháng 12/2018. Kết quả: DFS tại thời điểm 3 năm là 82,8% (95%CI 53,2-62,1). Gan và phổi là vị trí tái phát phổ biến chiếm tỷ lệ là 5,2%. OS tại thời điểm 3 năm là 90,8% (95%CI 58,7-64,9). Các yếu tố ảnh hưởng thuận lợi đến kết quả thời gian sống thêm bệnh không tiến triển 3 năm bao gồm: Bệnh đáp ứng sau hóa xạ trị (93,3% vs 85%, p <
0,001), giai đoạn N0 sau hóa xạ trị (87,3% vs 82,4% vs 0%, p <
0,001), điều trị đủ 6 chu kì hóa chất (86,8% vs 45%, p=0,001). Các yếu tố ảnh hưởng thuận lợi đến kết quả thời gian sống toàn bộ 3 năm bao gồm: tuổi ≤ 65 (91,5% vs 88,5%, p=0,024), số chu kì hóa chất đủ 6 (94,1% vs 62,5%, p=0,01). Tác dụng không mong muốn của phác đồ bổ trợ trên huyết học chủ yếu là độ 1,2 bao gồm thiếu máu (71,4%), hạ bạch cầu (50,6%), hạ bạch cầu hạt (45,5%) hạ tiểu cầu (39%). Tác dụng không mong muốn trên gan, thận ít gặp chủ yếu là độ 1,2. Các tác dụng không mong muốn khác ít gặp. Kết luận: Điều trị hóa chất bổ trợ cho bệnh nhân hóa xạ tiền phẫu và phẫu thuật triệt căn ung thư trực tràng là phương pháp có hiệu quả, an toàn.Evaluation of survival time for patients with rectal cancer stage cT3,4N1-2M0 receiving adjuvant chemotherapy after preoperative chemotherapy at K hospital and description some toxicity of adjuvant chemotherapy. Subjects and Methods: Retrospective describe study on 77 patients with stage cT3,4N1-2 rectal cancer who received adjuvant chemotherapy after preoperative chemotherapy at K hospital from January 2017 to December 2018. Results: DFS at 3 years were 82,8% (95%CI 53,2-62,1). The liver and lungs are common sites of recurrence, accounting for 5.2%. OS at 3 years was 90.8% (95%CI 58.7-64.9). The advantageous factors affected on the 3-year disease-free survival include: disease response after chemoradiotherapy (93.3% vs 85%, p <
0.001), stage N0 after chemoradiotherapy treatment (87.3% vs 82.4% vs 0%, p <
0.001), full 6 cycles of chemotherapy (86.8% vs 45%, p=0.001). The advantageous factors affected on the 3 years overall survival: age ≤ 65 (91.5% vs 88.5%, p=0.024), full 6 cycles of chemotherapy (94.1% vs 62.5%, p=0.01). The hematological toxicities were at grade 1 and 2 include anemia (71.4%), leukopenia (50.6%), agranulocytosis (45.5%), thrombocytopenia (39 %). Side effects on the liver and kidneys are rare, mainly grade 1 and 2. Other side effects are less common. Conclusion: Adjuvant chemotherapy for patients with preoperative chemotherapy and radical surgery for rectal cancer is an effective and safe method.

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1. Đọc trực tuyến

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