作者：魏哲威1，何裕隆1,2，余捷1，吴菁1，张常华1,2

单位：1.中山大学附属第一医院 胃肠外科中心，广东 广州 510080； 2.中山大学附属第七医院 胃肠外科，广东 深圳 518000

Authors:  WEI ZheWei1, HE Yulong1,2, YU Jie1, WU Jing1, ZHANG Changhua1,2

Unit:  1.Gastrointestinal Surgery, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510080, China;   2.Gastrointestinal Surgery, the Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen 518000, China

摘要：

目的  探讨mFOLFOX6与XELOX辅助化疗方案对于结直肠癌肝转移术后患者的临床价值。方法  回顾性分析2004年1月至2013年12月期间在中山大学附属第一医院行根治性手术的66例结直肠癌肝转移患者临床病理资料和预后,其中29例患者行mFOLFOX6化疗方案,37例患者接受XELOX化疗方案,探讨根治性手术后mFOLFOX6和XELOX方案对于结直肠癌肝转移患者的生存及预后的影响。结果 mFOLFOX6组的3年无复发生存率(disease free survival, DFS)为50.1%,XELOX组的3年无复发生存率29.4%(P=0.043)。两组之间的总生存率之间差异没有统计学意义(P=0.104)。Cox多因素回归分析显示术后行mFOLFOX6方案是结直肠癌肝转移根治术后患者的独立保护因素(HR=0.706, 95%CI:0.501～0.994, P=0.047)。结论  在结直肠癌可切除肝转移患者中,mFOLFOX6辅助化疗方案较XELOX方案疗效更好。

关键词： 结直肠癌肝转移; 辅助化疗; 奥沙利铂; 预后

Abstract：

Objective  We evaluated the effect of mFOLFOX6 and XELOX after radical resection of colorectal liver metastases (CLMs). Methods  Between June 2004 to December 2013, 66 patients received radical resection of CLMs were reviewed retrospectively and evaluable for overall survival (OS)and diseasefree survival (DFS). Results  The 3-year DFS rates were 50.1% for patients in the mFOLFOX6 group and 29.4% for patients in the XELOX group, respectively (P=0.043). mFOLFOX6 regimen was shown by univariate and multivariate analyses to be an independent factor predicting a better DFS (HR=0.706; 95%CI: 0.501-0.994, p=0.047). There was no significant difference in OS between the two groups. Conclusion  Adjuvant treatment with mFOLFOX6 was associated with better DFS compared to adjuvant treatment with XELOX for patients with resectable colorectal cancer and synchronous liver metastases.

Key Words:  Colorectal liver metastases; Adjuvant chemotherapy; Oxaliplatin; Prognosis