Effects of XELOX Neoadjuvant Chemotherapy on R0 Resection Rate and Malignant Tumor Marker Levels in Patients with Locally Progressive Low Rectal Cancer Undergoing Radical Resection
ZHEN Shenghua, WAN Qian, ZHANG Cheng, et al
Jianli People's Hospital, Hubei Jianli 433300, China
Abstract：Objective: To explore the effects of XELOX neoadjuvant chemotherapy on the R0 resection rate and levels of malignant tumor markers in patients with locally progressive low rectal cancer undergoing radical resection. Methods: Clinical data of 52 patients with locally progressive low rectal cancer who received radical resection in the hospital from August 2019 to August 2022 were retrospectively analyzed and the patients were included in control group. Clinical data of 53 patients with locally progressive low rectal cancer who underwent XELOX neoadjuvant chemotherapy + radical resection in the hospital during the same period were retrospectively analyzed and the patients were enrolled as observation group. The lesion resection status (R0 resection, R1 resection, R2 resection) in the two groups were analyzed. Anorectal dynamics [rectal resting pressure (RRP), rectal maximum tolerance volume (MTV), rectal compliance (RC)], malignant tumor markers [carcinoembryonic antigen (CEA), carbohydrate antigen 199 (CA199), tumor M2 pyruvate kinase (TuM2-PK)] and immune cells [T lymphocytes (CD3+, CD4+, CD4+/CD8+)] were compared between the two groups of patients before treatment and one week after surgery. Results: The R0 resection rate in observation group was higher than that in control group (P<0.05). One week after surgery, RRP in both groups was enhanced compared with that before treatment, but the RRP in observation group was lower than that in control group, and MTV and RC were reduced compared with those before treatment, but the two indicators in observation group were higher than those in control group (all P<0.05). The levels of CEA, CA199 and Tu M2-PK were declined compared to before treatment, and the levels were lower in observation group (all P<0.05). The levels of CD3+, CD4+ and CD4+/CD8+ in observation group were declined compared with those before treatment (all P<0.05), but there were no significant changes in control group (all P>0.05), and the differences between the two groups were statistically significant (all P<0.05). Conclusion: XELOX neoadjuvant chemotherapy can enhance the R0 resection rate, improve the anorectal dynamics and reduce the levels of malignant tumor markers in patients with locally progressive low rectal cancer undergoing radical resection, but it can reduce the immune function of patients.
2023, Vol. 29 
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