可切除低位直肠癌术前同步放化疗临床观察  

Clinical observation on preoperative concurrent radiochemotherapy of resectable low-set rectal cancer

作　　者：陈丽[1] 余美剑[1] 严新[1] 潘颖[1] 温宁笑[1] 

机构地区：[1]江西医学院一附院肿瘤科,江西南昌330006

出　　处：《世界肿瘤杂志》2011年第1期17-19,共3页Tumour Journal of the World

摘　　要：目的观察可切除低位直肠癌术前同步放疗化疗临床疗效及安全性。方法23例可切除低位直肠癌患者，术前子4野盆腔照射，放疗总剂量为46Gy。200cGy／f，5f／W，并于放疗第1、4周同步亚叶酸钙200mg，静脉输注d1～d5，氟脲嘧啶500mg／m^2／d，持续静脉输注d1-d5化疗，完成放化疗后，4周手术，术后4周，辅助化疗4周期，化疗方案奥沙利铂135mg／m^2d1亚叶酸钙200mg，静脉输注d1～d5，氟脲嘧啶500mg／m^2／d，持续静脉输注d1～d5化疗。结果治疗前T1期1例，T2期5例，T3期13例，T4期4例．局部淋巴结转移23例。放化疗后TON0期1例，T1N0期4例，T2N0期2例，T2NI期3例，T3N0期2倒，T3N1期3例，T4N0期1例，T4N1期1例。放化疗后T分期下降率34．78％（8例），N分期下降率为38．13％（9例）。术后病理与术前肠镜病理一致。全组保肛11例，保肛率47．83％。主要毒副反应为骨髓抑制、恶心、呕吐、腹泻、肛周皮肤反应等。23例患者全部完成术前同步放化疗，Ⅰ、Ⅱ级毒性反应总发生率为82．61％，Ⅲ、Ⅳ级毒性反应主要是腹泻4例为17．39％。无一例因术前放化疗而停止手术或者死亡。全组手术顺利，无一例发生围手术期死亡，并发症发生率为21．73％。结论可切除低位直肠癌术前同步放化疗安全、有效，值得临床推广使用。Objective To observe the clinical therapeutic effects and safety of preoperative concurrent radiochemotherapy in resectable low-set rectal cancer. Methods 23 cases of resectable low-set rectal cancer were given preoperative concurrent radiochemotherapy. Results T staging decreased by 34.78% （8 cases） after the concurrent radiochemotherapy, and N staging decreased by 38.13% （9 cases）. 47.83% patients （11 cases） accepted the sphincter preserving surgery. The main side effects included bone marrow depression, nausea, vomiting, diarrhea, cutaneous reaction. All the 23 patients finished the therapy, and no death occurred during the observation. Conclusions Concurrent radiochemotherapy is safe, effective to resectable low-set rectal cancer and worth promoting.

关 键 词：直肠癌 同步放化疗 疗效安全性 

分 类 号：R730.53[医药卫生—肿瘤] R730.55[医药卫生—临床医学]