局部晚期直肠癌术前新辅助放化疗的临床效果观察  

Effect of neoadjuvant chemoradiotherapy for local advanced rectal cancer

作　　者：李国强[1] 罗敬[1] 郑志坚[1] 陈爱辉[1] Li Guoqiang Luo Jing Zheng Zhijian Chen Aihui.(Department of Radiotherapy,Meizhou People＇s Hospital of Guangdong Province （Meizhou Hospital Affiliated to Zhongshan University）, Meizhou, Guangdong, 514000, China)

机构地区：[1]广东省梅州市人民医院(中山大学附属梅州医院)放疗科,广东梅州514000

出　　处：《结直肠肛门外科》2017年第3期345-348,共4页Journal of Colorectal & Anal Surgery

摘　　要：目的研究局部晚期直肠癌术前新辅助放化疗的临床价值。方法选取本院2010年12月至2013年5月92例局部晚期直肠癌手术患者为研究对象,随机分为观察组与对照组,每组各46例,观察组于直肠癌术前实施新辅助放化疗,对照组直接行手术治疗,比较两组不同时点TNM分期变化、术后1月疗效及3年随访结果,并记录新辅助放化疗期间不良反应发生率。结果新辅助治疗后观察组病理降期及术后观察组临床分期显著低于对照组(P<0.05);术后1月观察组RR率为80.43%,显著高于对照组(52.17%)(P<0.05);观察组2例出现血液系统不良反应,1例消化系统不良反应,经对症干预后缓解;观察组复发率为2.17%,显著低于对照组的17.39%(P<0.05),3年无病生存率为76.09%,显著高于对照组的58.70%(P<0.05)。结论术前新辅助放化疗可实现术前病理降期,从而增强手术疗效,术前新辅助放化疗虽有一定不良反应发生风险,但患者可基本耐受,且可显著改善直肠癌患者手术预后。Objective To study the clinical value of preoperative concurrent chemoradiotherapy for local advanced rectal cancer.Methods 92 patients with locally advanced rectal cancer from December 2010 to May 2013 in our hospital were studied. Patients were randomly assigned to treatment group and control group,with 46 cases in each group.The treatmentgroup was treated with neoadjuvant chemotherapy before operation,and the control group was treated with surgery. The changes of TNM staging at different time points in two groups and treatment effect at first month and three years after follow-up were compared between the two groups.Results After neoadjuvant therapy,the pathological stage and the clinical stage of the treatmentgroup were significantly lower than those of the control group（P〈0. 05）. One month after treatment,the RR rate of the treatmentgroup（80.43%）was significantly higher than that in the control group（P〈0. 05）.The observation group had 2 cases of adverse reactions to the blood system,1 case to the digestive system,both of which were successfully managed after intervention. The recurrence rate of the treatmentgroup was 2.17%,which was significantly lower than that of the control group（P〈0. 05）. 3 year disease-free survival rate（76.09%）in the treatment group was significantly higher than the control group（58.70%,P〈0. 05）.Conclusion Preoperative chemoradiotherapy can achieve preoperative pathological down-staging,thereby enhancing the efficacy of surgery. Ithas certain risk of but tolerable adverse reaction.Neoadjuvant chemotherapy can significantly improve the prognosis of patients with rectal cancer surgery.

关 键 词：晚期直肠癌 新辅助放化疗 临床疗效 

分 类 号：R735.37[医药卫生—肿瘤]