进展期中低位直肠癌术前同期放化疗的临床研究  

Clinical Research of the Preoperative Radiochemotherapy of Mid-low Locally Advanced Rectal Cancer

作　　者：李云峰[1] 熊伟[1] 高屹[1] 夏翠峰[1] 董建华[1] 

机构地区：[1]昆明医学院第三附属医院大肠癌临床诊疗中心,云南昆明650032

出　　处：《中国临床医学》2009年第5期731-733,共3页Chinese Journal of Clinical Medicine

基　　金：云南省教育厅科学研究基金项目(06y120c)

摘　　要：目的:探讨术前同期放化疗在进展期(T3、T4)中低位直肠癌治疗中的疗效。方法:将2006年10月—2008年10月60例中低位直肠癌患者随机分为两组:单纯放疗组在给单纯放疗后进行常规手术治疗;同期放化疗组在予希罗达(Xeloda)口服和同期放疗后再手术。对术前单纯放疗组与同期放化疗组的降期效果、手术切除率、保肛率、局部复发率及术后生活质量等进行比较。结果:同期放化疗组于放化疗结束后检查发现肿块均有不同程度缩小、活动度增加,降期、降级作用较单纯放疗组明显(P<0.05)。同期放化疗组和单纯放疗组的手术切除率分别为90%和66.7%,保肛率分别为63%和30%,两组比较均有显著性差异(P<0.05)。局部复发率分别为3.7%和10%,两组比较无统计学差异(P>0.05)。同期放化疗组术后生活质量明显优于单纯放疗组(P<0.01)。结论:术前Xeloda联合放疗对进展期中低位直肠癌是较好的新辅助治疗方案。Objective： To evaluate the efficacy of neoadjuvant radiotherapy alone versus chemoradiotherapy in patients with mid low loeally advanced recal cancer. Methods： Data of 60 patients with advanced （stage T3or T4 ）rectal eancer, undergone neoadjuvant therapy in our hospital from October 2006 to October 2008 were analyzed. Thirty patients received preoperative ra diotherapy （30 Gy, 3 Gy per fractions over 2 weeks） alone （Group A）, and 30 patients received preoperative radiotherapy concomitant with Xeloda based preperative chemoradiotherpy （Group B）. Surgery was done 2～4 weeks after this preoperative treatments. Results： Forty-seven patients underwent operations, including 15 abdominoperineal resections, 9 Hartmann＇s pro cedures and 23 anterior resections. In pathological findings, tumor and nodal downstaging were observed in 11 patients of Group A （36.7%）,and 18 of Group B （60%） （P〈0.05）. The sphincter preservation rate was 30%（6/20） in Group A, and 63% （17/27） in Group B （P〈0.05）. The Resection rates were 66.7 % and 90 % respectively （P〈0. 05 ）, Local recurrence rates were 10% and 3. 7% respectively （P〉0. 05 ）,The quality of life in Group A after operation were lower than that in Group B （P〈0. 01 ）. Conclusion： Combined preoperative xeloda and radiotherapy for lower rectal cancer is able to significantly improve the operative resection,anal preservation and amendment the quality of life after operation.

关 键 词：直肠癌 化疗 放疗 生活质量 

分 类 号：R735.37[医药卫生—肿瘤]