直肠癌术后局部复发的治疗  

Treatment of Postoperative Local Recurrence of Rectal Cancer

作　　者：孙洁[1] 李庆琪[1] 汪春林 刘峥[2] 

机构地区：[1]北京医科大学第一医院肿瘤治疗中心放疗科,北京市100034 [2]邯郸市中心医院放疗科

出　　处：《中国肿瘤临床》1999年第8期577-579,共3页Chinese Journal of Clinical Oncology

摘　　要：目的 :分析比较直肠癌术后局部复发不同治疗方法的疗效。方法 :1986～ 1993年收治 10 1例直肠癌术后局部复发的患者 ,49例单纯放疗 (Ⅰ组 ) ,2 5例单纯手术切除 (Ⅱ组 ) ,2 7例手术切除加放疗 (Ⅲ组 )。结果 :3组局部复发率分别为Ⅰ组 77.5 %、Ⅱ组 6 0 .0 %、Ⅲ组 2 9.6 % ,以Ⅲ组局部复发率最低 (P <0 .0 1) ,局部复发加远处转移率分别为Ⅰ组85 .7%、Ⅱ组 76 .0 %、Ⅲ组 5 9.2 % ,仍以Ⅲ组为最低 (P <0 .0 5 )。 3组 1年生存率分别为Ⅰ组 5 9.2 %、Ⅱ组 84.0 %、Ⅲ组 92 .5 % ,以Ⅲ组预后最佳 (P <0 .0 5 ) ,3年生存率分别为Ⅰ组 10 .2 %、Ⅱ组 16 .0 %、Ⅲ组 33.3% ,其中Ⅰ、Ⅲ组比较 ,Ⅲ组优于Ⅰ组 (P <0 .0 5 )。结论 :局部复发直肠癌患者手术加放疗优于单纯手术切除和单纯放射治疗。Purpose: To analyse the therapeutic effects of various treatments for local recurrent rectal cancer after operation. Methods: From 1986 to 1993, 101 patients with postoperative local recurrent rectal cancer were treated with various treatments. Forty-nine of them received only radiotherapy (group Ⅰ), 25 patients underwent operation (group Ⅱ) and 27 patients were treated by operation combined with radiotherapy (group Ⅲ). Results: Group Ⅲpatients had lower local recurrent rate (29 6%) than those of group Ⅱ(60 0%) and group Ⅰ(77 5%) ( P < 0 01). The local recurrence and distant metastasis rate of group Ⅲ(59.2%)was also lower than those of group Ⅱ(76 0%) and group Ⅰ(85 7%) ( P < 0 05). The 1-year survival rate of group Ⅲ(92 5%) was higher than those of group Ⅱ(84 0%)and group Ⅰ(59 2%) ( P < 0 05). The 3-year survival rate of group Ⅲ(33 3%) was also higher than those of group Ⅱ(16 2%) and group Ⅰ(10 2%) ( P < 0 05). Conclusion: Combination therapy of surgery plus radiation is better than radiation or surgery alone for patients with local recurrent rectal cancer after operation.

关 键 词：直肠癌 局部复发 手术后 

分 类 号：R735.370.5[医药卫生—肿瘤]