局部进展期直肠癌患者术前短程放疗与同步放化疗的效果对比  

The Efficacy of Brief Radiation Therapy and Synchronous Radio-chemotherapy at Preoperation of the Patients with Local Advanced Rectal Cancer:A Comparative Study

作　　者：曾庆范 张帆[1] 王颖拓 ZENG Qing-fan;ZHANG Fan;WANG Ying-tuo(Dept.of Radiation Therapy,Nanyang City's Central Hospital,Nanyang,Henan 473000)

机构地区：[1]南阳市中心医院放疗科,河南南阳473000

出　　处：《中国肛肠病杂志》2022年第5期4-6,共3页Chinese Journal of Coloproctology

摘　　要：目的:比较术前短程放疗与同步放化疗在局部进展期直肠癌患者中的应用效果。方法:回顾2017年于我院接受腹腔镜辅助直肠癌根治术治疗、术前接受短程放疗或常规同步放化疗且随访资料完整的73例局部进展期直肠癌患者资料,根据术前治疗方案不同分为短程放疗组(简称短程组,37例)和常规同步放化疗组(简称长程组,36例)。短程组放疗总剂量/每日剂量/天数为25Gy/5Gy/5d,放疗结束7d后手术。长程组放疗总剂量/每日剂量/天数为50Gy/2Gy/25d;放疗的同时口服卡培他滨片化疗;放疗结束7d后,常规XELOX方案化疗1个疗程;放疗后7周手术。以术后病理标本检查结果判定术前治疗效果。比较2组术前病理完全缓解(pCR)率、术前放疗毒副反应、术后并发症、手术保肛率、术后3年局部复发率及生存率。结果:长程组pCR率(27.78%)略高于短程组(21.62%),短程组术前放疗毒副反应发生率(16.22%)略高于长程组(11.11%),但差异均无统计学意义,P>0.05。短程组与长程组保肛率分别为75.68%和69.44%,术后并发症发生率分别为8.11%和8.33%,术后3年局部复发率分别为21.62%和19.44%,术后3年生存率分别为51.35%和55.56%,差异均无统计学意义,P>0.05。结论:局部进展期直肠癌患者术前短程放疗与常规同步放化疗,虽术前同步放化疗者pCR率略高,毒副反应略少,但两者术后并发症、术后3年局部复发及生存情况相近。考虑短程放疗治疗时间短、患者依从性好、费用低,故认为术前短程放疗可行。Objective To compare the efficacy of brief radiation therapy(BRT)and synchronous radiochemotherapy(SRCT)at preoperation of the patients with local advanced rectal cancer.Methods Retrospectively reviewed the 73patients’data which they treated in author’s hospital in 2017,all received BRT or route SRCT before the surgery for their local advanced rectal cancer,and with complete follow-up materials;they were divided into BRT group(37cases,had received BRT before surgery)and long course group(36cases,routine SRCT,at the same time):the former’s radiotherapy’s total dosage/daily dosage/days were 25Gy/5Gy/5days,7days radiotherapy later,the patients received surgery;meanwhile,the latter,respectively,50Gy/2Gy/25days,at the same duration,patients orally administered xeloda tablets-chemotherapy,7days after the end of radiotherapy,received routine XELOX schema chemotherapy for 1course,then,7weeks after the end of radiotherapy patients received surgery.In accord with postoperative pathological specimen exam.results,above preoperative curative efficacy was judged,then,both groups’preoperative pathological CR rate(i.e,pCR rate),preoperative radio-therapy’s adverse reaction,postoperative complication,the ratio of surgery-preserved anus,and the local recurrence rate 3years after surgery,as well as patients’survival rate were compared.Results Though in pCR rate,and in the adverse reaction induced by preperative radiotherapy between long-course group and BRT group there was difference(27.78%vs21.62%,11.11%vs 16.22%),but which had no statistical significance(P>0.05);At the same time,in the rate of surgery-preserved anus(69.44%vs 75.68%),in the rate of postoperative complication(8.33%vs8.11%),in the local recurrence rate 3years after surgery(19.44%vs 21.62%),and in the survival rate 3years after surgery(55.56%vs 51.35%),there also were no statistical difference(P>0.05).Conclusion Though preoperative SRCT has slightly higher pCR rate,less adverse reaction than BRT,but in postoperative complication and in the status on loc

关 键 词：局部进展期 直肠癌 术前 短程放疗 同步放化疗 效果 

分 类 号：R735.37[医药卫生—肿瘤]