术前新辅助放化疗在T3期直肠癌患者中的疗效研究  

The clinical efficacy of preoperative neoadjuvant chemoradiotherapy for rectal cancer patients at stage T3

作　　者：陈非[1] 罗舒[1] 夏徽[1] 唐俊丽[1] Chen Fei Luo Shu Xia Wei et al.(The First Hospital of Suining City, Sichuan,Suining 62900)

机构地区：[1]遂宁市第一人民医院,四川遂宁629000

出　　处：《基层医学论坛》2016年第25期3476-3478,共3页The Medical Forum

摘　　要：目的对术前新辅助放化疗用于T3期直肠癌患者的临床疗效进行观察。方法纳入T3期且无远处转移的直肠癌患者137例,根据是否接受术前新辅助放化疗分为新辅助放化疗组(n=76)及无新辅助放化疗对照组(n=61)。术前新辅助放化疗按标准方案进行,结束后评估患者情况并进行直肠癌根治手术。所有患者手术后观察其围术期并发症情况,并纳入随访,记录患者死亡、复发情况。结果新辅助放化疗组中53例(69.7%)出现肿瘤体积缩小,接受保留肛门手术比例高于对照组(44.7% vs 13.1%,P<0.05)。2组患者之间围术期并发症发生率相似,差异无统计学意义(P>0.05)。新辅助放化疗组3年肿瘤局部复发率(26.3%)显著低于对照组(37.7%),差异有统计学意义(P<0.05)。结论 T3期直肠癌患者手术前接受新辅助放化疗可增加保肛手术比例,改善远期预后。Objective To investigate clinical efficacy of the preoperative neoadjuvant chemoradio therapy for patients with T3 stage rectal cancer. Methods A total of 137 rectal cancer patients at T3 stage without distant metastases were enrolled retrospectively, and they were divided into neoadjuvant chemoradio therapy groups （n=76） and the no neoadjuvant chemoradio therapy （control） group （n=61）.After preoperative neoadjuvant chemoradio therapy was used, the patients were assessed and operated. Peri-operative complications were recorded after surgery in all patients. All the patients were regularly followed up, meanwhile the mortality, recurrence and loss to follow-up were recorded. Results In the neoadjuvant chemoradiotherapy group, tumor sizes in 53 （69.7%） patients reduced after neoadjuvant chemotherapy, the sphincter-preserving surgery rate was significantly higher than control group （44.7% vs. 13.1%, P〈0.05）.There were no significant differences of peri-operative complications between two groups （P〉0.05）. Neoadjuvant chemotherapy and three year local recurrence rate （26.3%） was significantly lower than the control group （37.7%） （P〈0.05）. Conclusion Preoperation neoadjuvant chemotherapy in patients with stage T3 rectal cancer can increase sphincter-preserving surgery rate, and improve the long-term outcome.

关 键 词：T3期直肠癌 新辅助放化疗 疗效 预后 

分 类 号：R735.37[医药卫生—肿瘤]