直肠癌术后静态调强放疗加化疗疗效和预后因素分析  

Curative effect and prognostic risk factors of static intensity modulated radiotherapy and chemotherapy after rectal cancer surgery

作　　者：马建光[1] 司小三[1] 

机构地区：[1]河南省周口市中心医院放疗科二病区,466099

出　　处：《中国实用医刊》2017年第13期55-58,共4页Chinese Journal of Practical Medicine

摘　　要：目的 分析直肠癌术后静态调强放疗加化疗的疗效和预后危险因素.方法 收集53例直肠癌患者的临床资料,所有患者均接受腹腔镜下或开腹直肠癌全直肠系膜切除术治疗和术后静态调强放疗加化疗.观察和统计所有患者放化疗不良反应发生情况,随访并统计所有患者1、3年总生存率,并通过单因素和多因素分析预后的危险因素.结果 53例直肠癌患者1、3年总生存率为92.45%、83.02%,不良反应发生率为28.30%.单因素分析结果显示影响直肠癌术后静态调强放疗加化疗预后3年总生存率的因素包括术前贫血、术前肠梗阻、肿瘤最大直径、分化程度、肿瘤浸润深度、淋巴结转移数、TNM分期、神经侵犯（P〈 0.05）.多因素分析结果显示淋巴结转移数〉4个、肿瘤低分化、肿瘤Ⅲ期、肿瘤浸润深度直肠系膜或浆膜、神经侵犯、术前贫血及术前肠梗阻均为影响术后静态调强放疗加化疗预后不良的因素.结论 直肠癌术后静态调强放疗加化疗可取得较好的临床疗效,可提高1、3年总生存率;但其预后受淋巴结转移数〉4个、肿瘤低分化、肿瘤Ⅲ期、肿瘤浸润深度达直肠系膜或浆膜、神经侵犯、术前贫血及术前肠梗阻等因素的影响.Objective To analyze the curative effect and prognostic risk factors of static intensity modulated radiotherapy and chemotherapy after rectal cancer surgery.Methods The clinical data of 53 patients with rectal cancer were sellected.All of the patients underwent laparoscopic or open total mesorectal excision for rectal cancer and postoperative intensity-modulated radiotherapy combined with chemotherapy intervention.The incidence of all adverse reactions of radiotherapy and chemotherapy were observed and statistically analyzed.The 1-year and 3-years total survival rates were also statistically analyzed.The prognostic risk factors were analyzed by univariate and multivariate analysis.Results The 1-year and 3-years total survival rates of the 53 cases were 92.45% and 83.02%, respectively;and the incidence of adverse reactions was 28.30%.Univariate analysis showed that the factors influencing the 3-years total survival rate after static intensity-modulated radiotherapy and chemotherapy for rectal cancer included preoperative anemia, preoperative intestinal obstruction, the maximum diameter of tumor, degree of differentiation, depth of tumor invasion, number of lymph node metastases, TNM staging and nerve invasion （P〈 0.05）.Multivariate analysis showed that number of lymph node metastases〉4, low tumor differentiation, tumor in stage Ⅲ, depth of tumor invasion being mesorectum or chorion, nerve invasion, preoperative anemia and preoperative intestinal obstruction were risk factors influencing the prognosis of postoperative intensity-modulated radiotherapy and chemotherapy.Conclusions The effect of static intensity-modulated radiotherapy and chemotherapy after rectal cancer surgery is good.It can increase the 1-year and 3-years overall survival rate;The prognosis can be affected by the number of lymph node metastases〉4, low tumor differentiation, tumor in stage Ⅲ, depth of tumor invasion being mesorectum or chorion, nerve invasion, preoperative anemia and preoperative obstruction.

关 键 词：直肠癌 静态调强放疗 化疗 预后 影响因素 

分 类 号：R735.37[医药卫生—肿瘤]