术前含氟尿嘧啶化疗联合调强放疗对直肠癌根治术患者病理分级、手术并发症及生存率的影响  

Effect of Fluorouracil Chemotherapy Combined with Intensity-Modulated Radiotherapy on Pathological Grading,Surgical Complication and Survival Rate in Patients Undergoing Rectal Cancer Radiotherapy Before Surgery

作　　者：王波[1] 陈剑锋[1] 尹小彬 梁启飞 黄俊伟[1] 张蓉[1] Wang Bo;Chen Jianfeng;Yin Xiaobin;Liang Qifei;Huang Junwei;Zhang Rong(Department of Gastrointestinal Surgery,Wenjiang District People＇s Hospital,Chengdu,Sichuan,China 611130)

机构地区：[1]四川省成都市温江区人民医院胃肠外科,四川成都611130

出　　处：《中国药业》2018年第15期49-51,共3页China Pharmaceuticals

基　　金：2012年度四川省医学科技攻关计划普通项目[120206]

摘　　要：目的探讨术前含氟尿嘧啶化学治疗(简称化疗)联合调强放射治疗(简称放疗)对直肠癌根治术患者病理分级、手术并发症及生存率的影响。方法选取2008年1月至2012年1月在医院行根治术治疗的直肠癌患者82例,回顾性分析临床及随访资料,根据治疗方案的不同分为对照组(40例)和观察组(42例)。对照组患者行根治术治疗前予以含氟尿嘧啶方案化疗,观察组患者在对照组治疗基础上联合调强放疗。结果观察组患者术后肿瘤病理退缩分级(TRG)4为28.57%,显著高于对照组的5.00%(χ~2=8.040,P=0.005);观察组患者术后T_3,T_4,N期肿瘤的降期率均显著高于对照组(P<0.05);两组患者术后并发症发生率比较无差异(P>0.05),但观察组患者术后3年复发率和远处转移率均显著低于对照组(P<0.05);观察组患者术后3年生存率为90.48%,显著高于对照组的70.00%(χ~2=5.470,P=0.019)。结论术前含氟尿嘧啶化疗联合调强放疗可明显改善直肠癌根治术患者术后的病理分级,降低其术后复发率和临床转移率,提高其肿瘤降期率和生存率,值得临床推广。Objective To investigate the effect of fluorouracil chemotherapy combined with intensity modulated radiotherapy（ IMRT） on the pathological grading, operative complications and survival rate in patients undergoing radical resection of rectal cancer before surgery. Methods Totally 82 patients undergoing radical resection of rectal cancer from January 2008 to January 2012 in our hospital were selected. The clinical data and follow-up data of all patients were analyzed retrospectively. The patients were divided into the control group（ 40 cases） and the observation group（ 42 cases） according to the different treatment regimens. The patients in the control group were treated with fluorouracil chemotherapy before radical resection of rectal cancer,on this basis,the patients in the observation group were treated with the IMRT. Results The postoperative tumor regression grade 4（ TRG4） of the observation group was 28. 57%,which was significantly higher than 5. 00% of the control group（ χ~2= 8. 040, P = 0. 005）. The expiration rates of tumors in T3, T4, N phases after surgery in the observation group were significantly higher than those in the control group（ P〈0. 05）. There was no significant difference in the incidence rate of complications between the two groups after surgery（ P〈0. 05）, but the recurrence rate and distant metastasis rate in the observation group were significantly lower than those in the control group within 3 years after surgery（ P〈0. 05）. The survival rate of patients within 3 years after operation in the observation group was 90. 48%,which was significantly higher than 70. 00% in the control group（ χ2= 5. 470, P = 0. 019）. Conclusion Before surgery,fluorouracil chemotherapy combined with IMRT can significantly improve the postoperative pathological grading, reduce the postoperative recurrence and metastasis rate in the patients undergoing radical resection of rectal cancer, and improve the tumor reduction rate and survival rate. It is worthy of clinical promo

关 键 词：术前 氟尿嘧啶 化学治疗 调强放射治疗 直肠癌 生存率 

分 类 号：R969.4[医药卫生—药理学] R979.1[医药卫生—药学]