直肠癌术后局部复发的放射治疗临床研究  

Radiotion therapy for local recurrence of postoperative rectal cancer patients

作　　者：李文竹[1] 王长胜[1] 张玉书[1] 

机构地区：[1]首都医科大学附属北京友谊医院放疗科,100050

出　　处：《北京医学》2006年第9期522-524,共3页Beijing Medical Journal

摘　　要：目的观察放射治疗直肠癌手术后复发患者的疗效。方法选择直肠癌术后复发、接受单纯放疗的49例患者,放疗总剂量为56～60Gy/28～30f,每周5次,放疗后1个月复查CT。结果本组随访3年。完全缓解3例(6.1%),部分缓解25例(51.0%),稳定15例(30.6%),进展6例(12.2%)。有效率为57.1%;疼痛缓解率为69.2%(27/39)。其1、2、3年生存率分别为57.1%、36.8%、6.1%。放疗剂量56Gy(40Gy+16Gy)与60Gy(46Gy+14Gy)两组相比,生存率无显著性差异,但前者急性放射性直肠炎明显减少。结论直肠癌患者术后2～3年内应定期复查,对于局部复发者,放射治疗是一种有效的治疗手段,放疗剂量选择56Gy(40Gy+16Gy)为宜。Objective To evaluate the radiation therapy for rectal cancer of postoperative local recurrence. Methods From March 1996 to March 2002, 49 patients with postoperative local recurrence rectal cancer were retrospectively analyzed. All patients were treated with radiation therapy. They first received 40-46Gy with larger field,then followed by a boost of 10-20Gy with reduced field ,The total dose was Dt 56-60C, y in 6 weeks. All patients were followed up for three years. Results The complete remission rate was 6.1%（3/49）, the partial remission rate was 51.0%（25/49）,the total response rate（CR＋PR） was 57.1%（28/49）.The pain-alleviation rate was 69.2%（27/39）. The 1, 2, 3 year survival rate was 57.1% （28/49）, 36.8%（18/49）, and 6.1%（3/49） respectively. The incidence of acute radiation proetitis for 56Gy（40Gy＋16Gy） was evidently increased compared with that of acute radiation proetitis for 60Gy （46Gy＋14Gy）, but the survival rate was similar. Conclusions Follow-up should be carried out 2-3 years after operation in patients of rectal cancer and radiotherapy is an effective treatment in patients with local recurrent rectal cancer, radiotherapy dose of 56Gy （40Gy＋16Gy） is compatible.

关 键 词：直肠癌 局部复发 手术 放疗 

分 类 号：R735.37[医药卫生—肿瘤]