| Objective: This study aimed to explore the safety and long-term impact of extremely early initiation(≤ 2 weeks)of Postoperative Adjuvant Chemotherapy(PAC)for Ⅱ/Ⅲ rectal cancer.Method: Patients with stage Ⅱ/Ⅲ rectal cancer treated from January 2013 to December2015 were retrospectively collected at department of Tongji Hospital.According to the starting point of PAC,patients were categorized into two groups: extremely early group(The interval of PAC≤ 2 weeks)and normal group(The interval of PAC within 3-5 weeks).For the sake of evaluating the effectiveness of different intervals in first 3 years,Overall Survival rate(OS),Progress-Free Survival rate(PFS)and Recurrence and Metastasis rate(RMR)were analyzed,as well as the Quality of Life(QOF)Score.To estimate the safety of the extremely early PAC,we calculated the biochemistry indexes around the first postoperative adjuvant chemotherapy,and analyzed the first postchemotherapy adverse reaction as well as defecation ability.Results: Compared to normal group,extremely early group of patients showed no significant statistical differences for OS and PFS(OS: P = 0.0930;PFS: P = 0.1058).However,the RMR was significant lower(P = 0.0452),the QOF Score was significant higher(P = 0.0090)in extremely early group.Multivariate analysis also showed thatextremely early group had a better defecation ability(P = 0.0149)and less side reactions of postchemotherapy,included nausea and vomiting(P < 0.0001),diarrhea(P = 0.0494),or constipation(P = 0.0054),meanwhile got a higher level of inflammatory cells(P < 0.0001)and worse liver function(P = 0.0020).Conclusion: For stage Ⅱ/Ⅲ rectal cancer patients,extremely early to start PAC not only might effectively prolong the survival,but decrease the recurrence and metastasis,increase their quality of life and decrease chemotherapy-associated adverse reaction.Meanwhile,appropriately controlling of inflammatory cells and protecting the liver function should be of concern to ensure the safety of early initial stage. |
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