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Pre-operative chemoradiotherapy (CRT) is a preferable treatment option for patients with locally advanced rectal cancer. However, few data are available regarding pre-operative CRT for locally advanced colon cancer. Here, we describe two cases of successful treatment with pre-operative CRT and establish evidence supporting this treatment option in patients with locally advanced colon cancer. In the first case, a 65-year-old woman was diagnosed with ascending colon cancer with duodenal invasion. In the second case, a 63-year-old man was diagnosed with a colonic-duodenal fistula due to transverse colon cancer invasion. These case reports will help to establish a treatment consensus for pre-operative CRT in patients with locally advanced colon cancer.
Subject(s)
Aged , Female , Humans , Middle Aged , Chemoradiotherapy , Colon , Colon, Ascending , Colon, Transverse , Colonic Neoplasms , Consensus , Fistula , Rectal NeoplasmsABSTRACT
Objective To observe the effect of two different chemotherapy regimens, including irinotecan, folinic acid and FU chemotherapy regimen (FOLFIRI) versus folinic acid, FU and oxaliplatin chemotherapy regimen (mFOLFOX6) on nutritional status in patients with advanced colon cancer. Methods A total of 110 patients with advanced colon cancer in Shanxi Cancer Hospital were divided into FOLFIRI (group A) and mFOLFOX6 (group B). To investigate the effect of two different regimens on the patients with advanced colon cancer by toxicity, the traditional methods of nutritional assessment, scored patient-generated subjective global assessment (PG-SGA), nutrition risk screening-2002 (NRS-2002). Shapiro-Wilk was used to detect the normality of small samples, t test was used to analyze measurement data conformed to the normal distribution, Wilcoxon non-parametric test was used to analyze the abnormal distribution data, and enumeration data was detected by using chi-square test. Results The incidence of vomiting, diarrhea and alopecia in group A and group B was respectively 53.8 % (28/52) vs. 29.3 % (17/58), 65.4 % (34/52) vs. 43.1 %(25/58),46.2 %(24/52)vs.20.7 %(12/58)respectively,and there was a significant difference(all P <0.05). The albumin, body mass index, NRS-2002 score, PG-SGA score after chemotherapy were significantly lower than those before chemotherapy in both groups (all P < 0.05). PG-SGA scores after chemotherapy in group A and group B were respectively 7.0 and 5.5 (Z= -2.026, P< 0.05). There were no statistically significant differences between the two groups in the albumin, body mass index, triceps skin fold (TSF), arm muscle weeks diameter(MAMC)and NRS-2002 score(all P >0.05).Conclusions FOLFIRI and mFOLFOX6 scheme can reduce the patient's nutritional status. The probability of gastrointestinal adverse reaction of FOLFIRI regimen is high, which may have an obvious impact on nutritional status of patients compared with mFOLFOX6 scheme.
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OBJECTIVE:To observe therapentic efficacy of bevacizumab combined with irinotecan+leucovorin+fluorouracil (FOLFIRI)plan in the treatment of advanced colon cancer,toxic reaction and patients'survival rate. METHODS:A total of 113 patients with advanced colon cancer admitted to the oncology department in our hospital from Jan. 2010 to Aug. 2014 were random-ized into observation group 1(40 cases),observation group 2(39 cases)and control group(34 cases). Three groups received FOLFIRI;observation group 1 and 2 were additionally given Bevacizumab injection 5 and 7.5 mg/kg 14 d as a treatment course, for 8 cycles. Clinical efficaices as well as the positive rate of VEGF-A,immune indexes(the proportion of CD3+,CD3+CD4+,CD3+CD8+ in T cell subset)before and after treatment,the incidence of toxic reaction,1-year and 2-year survival rates were compared among 3 groups. RESULTS:The total response rate of observation group 1 and 2 were significantly higher than control group,and the positive rate of VEGF-A in observation group 1 and 2 were significantly lower than control group,with statistical significance (P0.05). 2-year survival rate of observation group 1 and 2 were significantly higher than control group,with statistical significance(P<0.05). CONCLUSIONS:For advanced colon cancer,different doses of bevacizumab combined with FOLFIRI have significant synergistic effect,can effectively inhibit VE-FG-A,play a role of immune protection and anti-toxic side effects,and prolong the survival time. The incidence of hypertension in patients treated with low-dose bevacizumab is relatively lower and the safety is better.
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Objective To observe the effect of Chinese herbal medicine Ginseng nutrient-nourishing decoction combined with enteral nutrition on its nutritional status during chemotherapy in patients with advanced colon cancer. Methods A prospective study was conducted to analyze the clinical data of 160 patients with advanced colorectal cancer who were enrolled in the Chinese Medicine Section of the PLA General Hospital from January 2014 to January 2017. 160 patients were divided into treatment group and control group, 80 patients in each group. The patients in the treatment group were given traditional Chinese medicine Ginsengnutyient-nourishing decoction and enteral nutrition support treatment. The control group was given enteral nutrition Support treatment. The nutritional indicators, clinical efficacy, adverse reactions and immune indicators were compared between the two groups. Results The RR67.50% of the treatment group was higher than the control group (35.00%), and the DCR57.50% was higher than that of the control group (52.50%), but there was no significant difference between the two groups. Compared with the control group, the body mass index of the treatment group, the thickness of the triceps skin fold, the upper arm muscle, the total protein, the albumin and the prealbumin were better than the control group, the diffiences was statistically significant (P<0.05). The incidence of thrombocytopenia, thrombocytopenia, hemoglobin reduction, nausea and vomiting, arrhythmia, anorexia, alopecia and fever were significantly different between the two groups (P<0.05) , IgM (all significantly higher than the control group, the difference between the two groups was statistically significant (P<0.05). Conclusion Ginseng nutrient-nourishing decoction can improve the nutritional status of patients with advanced colon cancer chemotherapy, can play a role in reducing the adverse reactions of patients, effectively improve the immune function of patients, it is worth promoting.
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Objective To observe the effect of Chinese herbal medicine Ginseng nutrient-nourishing decoction combined with enteral nutrition on its nutritional status during chemotherapy in patients with advanced colon cancer. Methods A prospective study was conducted to analyze the clinical data of 160 patients with advanced colorectal cancer who were enrolled in the Chinese Medicine Section of the PLA General Hospital from January 2014 to January 2017. 160 patients were divided into treatment group and control group, 80 patients in each group. The patients in the treatment group were given traditional Chinese medicine Ginsengnutyient-nourishing decoction and enteral nutrition support treatment. The control group was given enteral nutrition Support treatment. The nutritional indicators, clinical efficacy, adverse reactions and immune indicators were compared between the two groups. Results The RR67.50% of the treatment group was higher than the control group (35.00%), and the DCR57.50% was higher than that of the control group (52.50%), but there was no significant difference between the two groups. Compared with the control group, the body mass index of the treatment group, the thickness of the triceps skin fold, the upper arm muscle, the total protein, the albumin and the prealbumin were better than the control group, the diffiences was statistically significant (P<0.05). The incidence of thrombocytopenia, thrombocytopenia, hemoglobin reduction, nausea and vomiting, arrhythmia, anorexia, alopecia and fever were significantly different between the two groups (P<0.05) , IgM (all significantly higher than the control group, the difference between the two groups was statistically significant (P<0.05). Conclusion Ginseng nutrient-nourishing decoction can improve the nutritional status of patients with advanced colon cancer chemotherapy, can play a role in reducing the adverse reactions of patients, effectively improve the immune function of patients, it is worth promoting.
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PURPOSE: In locally advanced adherent colon cancer surgery, a mutivisceral resection is known to reduce local recurrence and improve survival. Practically, the benefit of using this procedure may outweigh the risk of associated morbidity, but the procedure may not be performed uniformly. We reviewed the results of multivisceral resections for locally advanced colon cancer. METHODS: From 2003 January to 2008 January, 476 colon cancer patients underwent surgery for locally advanced colon cancer in our hospital. Out of the 476 patients, 36 patients with pT3-pT4 who underwent any kind of adjacent organ resection other than a resection of the colon were reviewed retrospectively. RESULTS: Out of the 36 patients, 22 were male and 14 were female, and the mean age was 63.44+/-13.26 yr. The sigmoid colon was the most common location for the primary lesion, followed by the ascending colon, the transverse colon, and the cecum. Invaded organs were the abdominal or pelvic wall in 5 patients, the visceral organs in 26 patients, the retroperitoneum in 2 patients. All patients received an en-bloc resection of the invaded organs. Ten patients were stage II, 14 patients were stage III, and 12 patients were stage IV. Fifteen patients were disease free at the end of this study, local recurrence had occurred in 1 patient, 6 patients had an intraabdominal recurrence, and 2 patients had developed a distant metastasis. The overall complication rate was 28%. The 5-yr survival rate of each stage according to the surgical approach did not show any meaningful difference. CONCLUSION: A multivisceral en-bloc resection has been recommended for locally advanced adherent colon cancer patients. To improve the outcome, we suggest progressive surgical treatment in such patients.
Subject(s)
Female , Humans , Male , Cecum , Colon , Colon, Ascending , Colon, Sigmoid , Colon, Transverse , Colonic Neoplasms , Neoplasm Metastasis , Recurrence , Retrospective Studies , Survival RateABSTRACT
Objective To evaluate the effects of intraoperative intraperitoneal chemotherapy with sustained release 5-fluorouracil for implantation(5-Fu SRI) for the treatment of locally advanced colon cancer. Methods A total of 70 patients with locally advanced primary colon cancer(T4N0M0 and stage Ⅲ) undergoing radical resection were divided into treatment group(n=36,intraoperative intraperitoneal chemotherapy with 600mg 5-Fu SRI)and control group(n=34,intraoperative intraperitoneal flushing with 1000mg 5-fluorouracil injection). Both groups received the same postoperative chemotherapy regime.The 2-year survival rate,local recurrence rate and distant metastasis rate were retrospectively analysed. Results The 2-year survival rate and local recurrence rate were more favourable in treatment group than those in control group(P0.05). Conclusion Intraoperative intraperitoneal chemotherapy with 5-Fu SRI may decrease postoperative local recurrence rate and increase 2year survival rate.