术前同步放化疗联合全直肠系膜切除术治疗中低位局部晚期直肠癌的疗效  

Efficacy of preoperative concurrent chemoradiotherapy and total mesorectal excisionin in treatment of locally advanced middle and lower rectal cancer

作　　者：金珊[1] 谭诗生[1] 李杭[1] 蒋莹[1] 冯志宇[1] 王玮[1] 

机构地区：[1]贵州省人民医院肿瘤科,贵阳550002

出　　处：《中国肿瘤临床与康复》2015年第7期824-826,共3页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨术前同步放化疗联合全直肠系膜切除术（TME）治疗中低位局部晚期直肠癌的疗效。方法给予75例中低位局部晚期直肠癌患者（T3~4N0M0期或T1~2N1~2M0期）进行新辅助同步放化疗,放化疗结束后行全直肠系膜切除术（TME）,观察治疗效果。结果 75例患者均完成术前同步放化疗,其中完全缓解（CR）13例,部分缓解（PR）50例,疾病稳定（SD）12例,84.0%（63/75）的患者临床分期下降。75例患者均接受了手术治疗,总保肛率为66.7%（50/75）,无一例发生围手术期死亡,术后并发症发生率为20.0%（15/75）。结论术前同步放化疗联合TME治疗中低位局部晚期直肠癌安全、有效,可以降低肿瘤分期,提高保肛率,提高患者生活质量。Objective To evaluate the efficacy of preoperative concurrent chemoradiotherapy and total mesorectal excisionin （TME） in treatment of locally advanced middle and lower rectal cancer. Meth- ods Seventy-five patients with locally advanced middle and lower rectal cancer were received neoadjuvant concmxent chemoradiotherapy （T3 -4NOMO or T1 -2N1 -2M0）. The total mesorectal excisionin was per- formed 4 - 6 wk after concurrent chemoradiotherapy. The efficacy was observed. Results Seventy-five pa- tients completed the neoadjuvant concurrent chemoradiotherapy, and 13 cases was complete response （CR） , 50 cases was partial response （PR） , 12 cases was stable disease （SD） , and 63 patients （84. 0% ） obtained downstaging. All patients received TME. No perioperative death was observed, and the overall in- cidence of complication was 20.0% （15/75）. Conclusions Neoadjuvant concurrent chemoradiotherapy combined with TME for treatment of locally advanced middle and lower rectal cancer is effective and safe, which can reduce the tumor stage and increase sphincter preservation rete, and can also improve the quality of life of patients.

关 键 词：直肠肿瘤 新辅助治疗 同步放化疗 全直肠系膜切除术 

分 类 号：R735.37[医药卫生—肿瘤]