| Background&Objective:Colorectal cancer is one of the most common cancers in the world,with morbidity and mortality accounting for the third highest in all cancers.In recent years,the morbidity and mortality of colorectal cancer in our country also show an upward trend,with the morbidity in the third place and the death rate in the fifth place.NCCN guidelines recommend that patients with high-risk stage ? and ?colorectal cancer should receive six months of postoperative adjuvant chemotherapy.However,due to the toxic side effects of chemo-therapy,especially the peripheral neurotoxicity of oxaliplatin,some patients in clinic may not be able to complete the treatment on schedule.So whether it can reduce the efficacy of the premise,by reducing the chemotherapy time to reduce the side effects of chemotherapy it?The purpose of this study was to retrospectively analyze the effect of postoperative adjuvant chemotherapy for colorectal cancer on 3-year disease-free survival(DFS)in high-risk stage ? and ? colorectal cancer.Methods:From January 2010 to December 2014,294 patients with colorectal cancer who underwent radical mastectomy were enrolled in the First Affiliated Hospital of Dalian Medical University.Among them,120(40.8%)were women and 174(59.2%)were men.There were 125 cases(42.5%)in stage ? and 169 cases(57.5%)in stage ?,94 cases(32.0%)of right colon cancer,111(37.7%)left colon cancer and 89%).There were 19 cases of well-differentiated adenocarcinoma(6.4%),194 cases of moderately differentiated adenocarcinoma(66.0%),52 cases of poorly differentiated adenocarcinoma(17.7%),7 cases of signet-ring cell carcinoma(2.4%)and 22 cases of mucinous adenocarcinoma 7.5%).All 294 patients received postoperative chemotherapy with 5-FU/CF or capecitabine+oxaliplatin for at least 2 cycles.Including 251 patients receiving oxaliplatin-containing chemotherapy and receiving either capecitabine monotherapy or 5-FU/CF regimen in 43 cases.According to the postoperative adjuvant chemotherapy time is divided into three groups of less than or equal to 3 months,3-6 months(excluding 3 months but including 6 months)two groups.Adverse reactions were assessed according to the Common Terminology Criteria for Adverse Events(CTCAE)Version 4.0.The main observation index was 3-year DFS,and the secondary observation index was the classification and grading of adverse reactions.Access to electronic medical records or telephone follow-up,follow-up deadline for January 2018.SPSS 21.0 statistical software was used for statistical analysis,count data between the groups using ?2 test;using Kaplan-Meier method analysis of postoperative adjuvant chemotherapy on disease-free survival,COX regression model for multivariate analysis,p<0.05 Explain the difference was statistically significant.ResultChemotherapy time:72 patients(24.5%)were treated with chemotherapy less than 3 months,32 patients had recurrence and metastasis.222 patients(75.5%)had chemo-therapy time 3-6 months and 73 patients had recurrence and metastasis.The three-year DFS of the two groups were 55.6%and 67.1%.The difference was statistically significant(P=0.101).The incidence of ?-? peripheral nerve toxicity in both groups was 16.7%and 51.8%.Grade ?-? peripheral nerve toxicity rates were 1.4%and 4.1%.The difference was statistically significant(P=0.000).The incidence of ?-? hand-foot syndrome was 8.3%and 20.7%.The incidence of ?-? hand-foot syndrome was 0.0%and 2.7%,respectively.The difference was statistically significant(P=0.037).There were no differences in myelosuppression,nausea and vomiting,diarrhea and liver function impairment significance.The tumor site:Three-year DFS in right colon,left colon and rectal cancer was 66.0%,73.0%,and 51.7%.The difference was statistically significant(P=0.004).Tumor stage TNM:Among the 294 patients,the 3-year DFS of patients with stage? and stage ? was 84.0%and 49.7%,respectively.The difference was statistically significant(P=0.000).Pathological differentiation:Three years of DFS in well-differentiated adenocarcinoma,moderately differentiated adenocarcinoma,poorly differentiated adenocarcinoma,signet-ring cell carcinoma,and mucinous adenocarcinoma were 84.2%,67.0%,48.1%,42.9%,and 68.2%.The difference was statistically significant(P=0.025).T stage of tumor:The 3-year DFS of patients with T3,T4a,and T4b were 72.5%,58.6%,and 45.4%.The difference was statistically significant(P=0.025).Gender,age was not statistically significant.Conclusion:1.Colorectal cancer postoperative adjuvant chemotherapy time?3 months and 3-6 months in both groups,3-year disease-free survival was no significant difference.2.Colorectal cancer postoperative adjuvant chemotherapy time?3 months and 3-6 months in both groups,terminal neurotoxicity and hand-foot syndrome were statistically significant.3.Univariate analysis showed that lymph node N staging,T staging,tumor location,and pathological differentiation were the factors affecting the 3-year disease-free survival of colorectal cancer.Multivariate analysis showed that lymph node N staging was an independent factor affecting 3-year disease-free survival. |
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