Ⅱ、Ⅲ期直肠癌根治术后放疗同步希罗达化疗的疗效  

Efficacy of postoperative concurrent radiotherapy and chemotherapy with Xeloda for stage Ⅱ/Ⅲ rectal cancer

作　　者：陆忠华[1] 王建华[1] 许锡元[1] 周健[1] 

机构地区：[1]苏州大学附属常州肿瘤医院放疗科,江苏省常州市213002

出　　处：《世界华人消化杂志》2009年第32期3351-3354,共4页World Chinese Journal of Digestology

摘　　要：目的:回顾性分析Ⅱ、Ⅲ期直肠癌患者术后放疗同步联合希罗达化疗的疗效.方法:2000-01/2004-12收治直肠癌根治患者103例.按治疗方法分为3组.(1)单纯手术组(n=23),行Mile's或Dixon式根治术;(2)术后同步放化疗组(n=32),患者先行Mile's或Dixon式根治术,术后2wk开始放疗,每4.6-5wk DT 46-50 Gy/23-25次;放疗第1天起同时行化疗,希罗达1600mg/(m2·d),每天2次,第1-14天,每3wk重复1个疗程,共4-6个疗程;(3)术后序贯放化疗组(n=48),手术及放疗方法同上,化疗结束后给予放疗.奥沙利铂130mg/(m2·d),每天1次,第1-14天;希罗达1000mg/(m2·d),每天2次,第1-14天,每3wk重复1个疗程,共4-6个疗程.结果:术后同步放化疗组5年生存率为62.5%,高于单纯手术组的52.2%(P=0.024),但与序贯放化疗组(54.2%)相似(P=0.077);同步放化疗组局部复发率为6.25%,明显低于序贯放化疗组的31.25%(P=0.007)及单纯手术组(39.13,P=0.008);序贯放化疗组的局部复发率低于单纯手术组,但无明显差异(P=0.511).同步放化疗组的3/4度不良反应与序贯放化疗组相比无差异.结论:放疗联合希罗达同步治疗Ⅱ、Ⅲ期直肠癌术后患者可显著降低肿瘤局部复发率,5年生存率高于单纯手术,不良反应与序贯放化疗相比并未增加.AIM：To retrospectively analyze the efficacy of postoperative concurrent radiotherapy and chemotherapy with Xeloda for stage Ⅱ/Ⅲ rectal cancer. METHODS：A total of 103 rectal cancer patients who underwent radical surgery from January 2001 to December 2004 at our hospital were included in the study.These patients were divided into three groups：patients undergoing radical resection alone（surgical treatment group,ST; n=23）,those undergoing concurrent radiochemotherapy after radical resection（postoperative concurrent radiochemotherapy group,PCR;n= 32）,and those undergoing sequential radiochemotherapy after radical resection（postoperative sequential radiochemotherapy group,PSR;n =48）.Two weeks after surgery,patients in the PCR group received radiotherapy consisting of DT 46-50 Gy in 23-25 fractionations over 4.6-5 weeks,concurrent with 4-6 cycles of chemother-apy[each cycle consisting of 14 days of Xeloda （800 mg/m^2 ,bid）followed by seven days off], while those in the PSR group received thesame radiotherapy as the PCC group,followed by 4-6 cycles of chemotherapy[each cycle consisting of 14 days of oxaliplatin（130 mg/m^2 ,qd）and capecitabine（500 mg/m^2 ,bid）followed by seven days off]. RESULTS：The 5-year survival rate in the PCR group was significantly higher than that in the ST group（62.5%vs 22.5%;P=0.024）,but comparable with that in the PSR group（62.5%vs 54.2%;P=0.077）.The local recurrence rate was significantly lower in the PCR group than in the PSR group and ST group（6.25%vs 31.25% and 39.13%;P=0.007 and 0.008,respectively）. No significant difference was noted in the local recurrence rate between the PSR group and ST group（P=0.511）.No significant difference was also noted in the incidence of grade 3/4 side effects between the PCR group and PSR group. CONCLUSION：Postoperative concurrent radiotherapy and chemotherapy with Xeloda is superior to radical resection alone in decreasing the local recurrence rate and improving the 5-year survival rate in stage Ⅱ/Ⅲ rec

关 键 词：直肠癌 放射治疗 希罗达 同步治疗 

分 类 号：R735.37[医药卫生—肿瘤]