简化调强放疗同步卡培他滨治疗直肠癌术后复发临床观察  

Short-term efficacy of simplified intensity-modulated radiation therapy combined with Capecitabine for postoperative recurrent rectal carcinoma

作　　者：张培良[1] 张佃富[1] 

机构地区：[1]山东省临沂市沂水中心医院肿瘤科,山东沂水276400

出　　处：《中华肿瘤防治杂志》2012年第14期1103-1105,共3页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的:观察直肠癌术后复发患者简化调强放疗(sIMRT)同步卡培他滨化疗的近期疗效和不良反应。方法:33例直肠癌术后复发患者均行sIMRT〔先行盆腔淋巴引流区及直肠周围放疗(45～50)Gy/(25f.5w),复发病灶局部加量18～20Gy,(1.8～2.0)Gy/次,5次/周,总剂量达63～70Gy〕,并同步卡培他滨化疗(1 000mg/m2,从放疗第1天开始,连服14d,休息7d为1个周期,放疗期间口服2个周期)。放疗结束后行同方案巩固化疗2个周期。结果:全部患者均完成治疗,33例患者中CR 5例(15.2%),PR 20例(60.6%),NC 6例(18.2%),PD 2例(6.1%),总有效率75.8%。血清CEA下降50%并维持≥1个月者21例(84.0%)。治疗后临床症状改善和明显好转29例(87.9%)。主要不良反应是血液学毒性、消化道反应、急性膀胱炎和手足综合征等,均可耐受。结论:调强放疗联合卡培他滨同步化疗治疗直肠癌术后复发患者,不良反应轻,近期疗效确切,值得在临床上进一步探讨应用。OBJECTIVE： To evaluate the short-term efficacy of simplified intensity modulated radiation therapy （slMRT） combined with Capecitabine for postoperative recurrent rectal carcinoma. METHODS： Thirty-three patients with postoperative re- current rectal carcinoma received slMRT （pelvic lymphatic drainage area and around the rectum received radiotherapy with 45-50 Gy/25 f · 5w, the locally recurred lesion 18-20 Gy, 1.8-2.0 Gy/f, 5 times a week, total dose 63-70 Gy）. Synchronous chemotherapy with Capecitabine （1 000 mg/m2 orally from the first day of radiotherapy, 1 cycle with 14 days of administration, 7 days of rest, totally 2 cycles during the radiotherapy）. Another 2 cycles of same chemotherapy after the end of radiotherapy. RESULTS.. All the patients completed the regime safely. The complete remission rate was 15.2 %, partial remission rate 60. 6 %, stable disease rate was 18.2 %, and the progressive disease rate was 6.1%. The total efficiency rate （CR＋PR） was 75.8 %, and the clinical symptoms improved 87. 9%. The patients with CEA decreaseing for more than 50% and lasting for more than 1 month were 21 cases（84. 0 %）. The main side effects could be tolerated. CONCLUSION： sIMRT combined with Capecitabine for postoperative local recurrence of rectal cancer is safe with mild adverse reactions, convenient administration, confirmed shortterm efficacy and worthy for further study.

关 键 词：简化调强技术 放射疗法 直肠癌 治疗 卡培他滨 化学治疗 近期疗效 

分 类 号：R735.37[医药卫生—肿瘤]