直肠癌术后复发的综合治疗疗效分析  

Effect of combined modality for locally recurrent rectal cancer

作　　者：马剑波[1] 施健[1] 季斌[1] 陈不尤[1] 顾红梅[1] 

机构地区：[1]南通大学附属医院放疗科,江苏南通226001

出　　处：《现代肿瘤医学》2009年第5期891-893,共3页Journal of Modern Oncology

摘　　要：目的:探讨直肠癌术后复发的综合治疗方式及疗效。方法:手术后局部复发的直肠癌患者14例单纯采用常规放射治疗(单放组),21例在常规放射治疗后化疗(序贯组),15例在常规照射40Gy后行三维适形放射治疗,同步化疗(适形同步组),化疗方案主要有5-FU/LV,草酸铂+5-FU,草酸铂+希罗达。结果:症状缓解率单放组为7/9,序贯组11/13,适形同步组9/10(P>0.05)。单放组、序贯组、适形同步组的有效率分别为64.3%、71.4%、86.7%(P>0.05)。单放组中位生存时间为14个月,1、2、3年生存率分别为57.1%、28.6%、14.3%;序贯组中位生存时间为19个月,1、2、3年生存率分别为71.4%、42.9%、23.8%;适形同步组中位生存时间为25个月,1、2、3年生存率分别为80%、56.6%、38.8%;适形同步组与单放组的比较差异有显著性意义(P=0.0361)。3组不良反应可以耐受。结论:三维适形放射治疗+同步化疗可延长术后复发直肠癌患者的生存时间,是有效的综合治疗方式。Objective： To study the effect of combined modality for rectal cancer of postoperative local recurrence. Methods：Fifty patients with locally recurrent rectal cancer were treated between May 1997 and May 2006. Fourteen patients received radiotherapy alone （ RT group） ,21 patients received radiotherapy followed by chemotherapy （ RT ＋ CT group）, 15 patients received external beam radiotherapy to a total dose of 40 Gy then received 3D -CRT plus chemotherapy （3 D - CRT ＋ CT group）, chemotherapy included 5 - FU/LV, OXA ＋ 5 - FU and OXA ＋ Xeloda. Results： The symptom - alleviation rates were 7/9,1 1 / 13 and 9 / 10, while the overall response rates were 64.3 %, 71.4% and 86.7 % in RT group, RT ＋ CT group and 3 D - CRT ＋ CT group （ P 〉 0.05）. The median survival and 1 - ,2 - ,3 - year survival rates were 14 months ,57.1% ,28.6% , 14.3% for RT group;19 months ,71.4% ,42.9%, 23.8% for RT ＋ CT group;25months,80% ,56.6% ,38.8% for 3D - CRT ＋ CT group. The difference of survival rate between RT group and 3D - CRT ＋ CT group was statistically significant （P = 0. 0361 ）. The side effects were tolerate in the three groups. Conclusion：3D - CRT plus chemotherapy may prolong the survival time in locally recurrent rectal cancer and the combined modality therapy is an effective method.

关 键 词：直肠肿瘤 三维适形放射治疗 化学疗法 

分 类 号：R735.3[医药卫生—肿瘤]