Journal of Southern Medical University ›› 2015, Vol. 35 ›› Issue (04): 562-.
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Abstract: Objective To study the effect of perioperative immunomodulatory therapy on postoperative recurrence of rectalcancer. Methods This prospective study was conducted among 238 rectal/anal cancer patients undergoing intersphinctericresection at our center between January, 2010 and January, 2011, among whom 150 were eligible to be included and completedthe study. The 150 patients were randomized in a double-blinded fashion into 3 equal groups to receive immunomodulatorytherapy with 8 mg/kg celecoxib (group A), 0.4 mg/kg Sou-Medrol (group B), or placebo (group C), given daily from 5 daysbefore surgery to 5 days after surgery, and the postoperative cancer recurrence were compared. Results At 3 days after theoperation, the 3 groups showed significantly different C-reactive protein (CRP) levels, which decreased obviously in all the 3groups compared with those at 1 day following the operation (P=0.022), especially in group B. The levels of interleukin-6 (IL-6)at 3 days after the operation also differed significantly between the 3 groups but were lower in all the 3 groups than those at 1day after the operation (P=0.046), and this reduction was the most obvious in group A. COX-2 expression differed significantlybetween the 3 groups (P=0.017), among which group A showed the most obvious suppression of COX-2 expression. During thefollow-up for a mean of 45 months, no significant difference in the recurrence rate was found between the 3 groups (P=0.549).Conclusion With a lower efficacy than Sou-Medrol in decreasing postoperative inflammation, celecoxib produces a bettereffect in inhibiting COX-2 expression, but it does not lower postoperative recurrence rate of rectal cancer.
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https://www.j-smu.com/EN/Y2015/V35/I04/562