中低位进展期直肠癌患者采取新辅助放化疗的临床效果观察  

Clinical Effect Observation of Neoadjuvant Chemoradiotherapy for Patients with Middle and Low Advanced Rectal Cancer

作　　者：李俊[1] 陈飞[1] 杨宏山[1] 罗海宁 LI Jun;CHEN Fei;YANG Hongshan(Xiaogan Hospital Affiliated to Wuhan University of Science and Technology,Xiaogan 432000,China)

机构地区：[1]武汉科技大学附属孝感医院,湖北孝感432000

出　　处：《中国医学创新》2017年第36期87-90,共4页Medical Innovation of China

基　　金：湖北省卫生厅科研基金项目(JXIC36)

摘　　要：目的:分析中低位进展期直肠癌患者采取新辅助放化疗的临床效果。方法:选取2013年2月-2016年2月收治的50例中低位进展期直肠癌患者为研究对象,对所有患者进行新辅助放化疗治疗,对其临床疗效进行研究分析。结果:50例患者经过新辅助放化疗后,其肿瘤TNM分期均在不同程度上降低,5例T_4N_(1~2)M_0患者与10例T_4N_0M_0患者全部降期,并且放化疗后没有T_4N_(1~2)M_0、T_4N_0M_0患者存在。新辅助放化疗前,患者平均肿块最长径为(4.68±1.45)cm,治疗后减小到(2.29±1.12)cm,差异有统计学意义(P<0.05)。新辅助放化疗前,患者平均肿瘤距肛缘距离为(5.58±1.46)cm,治疗后增加到(6.98±1.88)cm,差异有统计学意义(P<0.05)。50例患者治疗后的手术病理学检测结果显示,9例患者为TRG4,15例为TRG3,9例为TRG2,10例为TRG1,7例为TRG0。50例患者保肛率为96%,所有患者均能够对新辅助放化疗耐受,在不同程度上出现了腹泻、呕吐以及恶心等消化道症状,部分患者有骨髓抑制现象出现,没有患者死亡。结论:中低位进展期直肠癌患者临床采取新辅助放化疗的临床疗效显著,肿瘤TNM降期明显,能够促使肿瘤得到有效缓解,值得广泛推广应用。Objective:To analyze the clinical effect of neoadjuvant chemoradiotherapy in the middle and low advanced rectal cancer patients.Method:50 middle and low advanced rectal cancer patients treated from February 2013 to February 2016 were selected as the research subjects,all patients were treated with neoadjuvant radiotherapy and chemoradiotherapy,and the clinical efficacy was studied and analyzed.Result:After neoadjuvant radiotherapy and chemotherapy,the TNM stage of 50 patients were reduced to varying degrees,5 cases of T4N1-2M0 and 10 cases of T4N0M0 were all down,there were no T4N1-2M0 and T4N0M0 patients after radiotherapy and chemotherapy existed.Before neoadjuvant chemoradiotherapy,the average diameter of the patients was(4.68±1.45)cm and decreased to(2.29±1.12)cm after treatment,the difference was statistically significant(P<0.05).Before neoadjuvant chemoradiotherapy,the average distance from the tumor to the anal margin was(5.58±1.46)cm and increased to(6.98±1.88)cm after treatment,the difference was statistically significant(P<0.05).The pathological examination results of 50 patients after treatment showed that 9 patients were TRG4,15 cases were TRG3,9 cases were TRG2,10 cases were TRG1,7 cases were TRG0.The retention rate of anal sphincter in 50 patients was 96%,all patients were able to tolerate neoadjuvant chemotherapy and radiotherapy,to some extent,diarrhea,vomiting and nausea were found,some patients had myelosuppression and no patients died.Conclusion:The clinical effect of neoadjuvant chemoradiotherapy in middle and low rectal cancer patients is significant,and the tumor TNM decrease stage is obvious,which can promote the tumor to be effectively alleviated,it is worth popularizing widely.

关 键 词：中低位进展期直肠癌 新辅助放化疗 临床效果 

分 类 号：R735.37[医药卫生—肿瘤]