同步新辅助放化疗联合TME对中低位局部进展期直肠癌患者的影响  

Effect of Synchronous Neoadjuvant Radiotherapy and Chemotherapy Combined with TME in Patients with Middle and Low Position Local Progressive Stage Rectal Cancer

作　　者：陈龙[1,2] 高峰[3] CHEN Long;GAO Feng(Gansu University of Traditional Chinese Medicine,Lanzhou 730000,China;不详)

机构地区：[1]甘肃中医药大学,甘肃兰州730000 [2]兰州市第二人民医院 [3]中国人民解放军联勤保障部队第九四〇医院

出　　处：《中外医学研究》2022年第25期33-37,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨同步新辅助放化疗联合全直肠系膜切除术(TME)对中低位局部进展期直肠癌患者的影响。方法:回顾性选取2018年6月-2021年6月中国人民解放军联勤保障部队第九四〇医院结直肠外科及其放疗科等收治的80例中低位局部进展期直肠癌患者。按治疗方式的不同将其分为对照组和观察组,各40例。对照组给予TME治疗,观察组给予同步新辅助放化疗联合TME治疗。比较两组治疗前后肿瘤标志物、血清标志物、排便功能、根治性切除率及保肛率、临床疗效。结果:治疗后,观察组癌胚抗原(CEA)、糖链抗原242(CA242)、糖链抗原19-9(CA19-9)、脂肪酸合成酶(FAS)、肿瘤型M2丙酮酸激酶(Tu M2-PK)水平均低于对照组(P<0.05)。治疗后,观察组保肛患者低位前切除综合征量表(LARS)评分低于对照组保肛患者(P<0.05)。观察组根治性切除率、保肛率均高于对照组(P<0.05)。治疗后3个月,观察组总有效率高于对照组(P<0.05)。结论:给予中低位局部进展期直肠癌患者同步新辅助放化疗联合TME,可以降低其肿瘤、血清标志物水平,提升其排便功能和保肛率,确保切除率和临床疗效。Objective:To investigate the synchronous neoadjuvant radiotherapy and chemotherapy combined with total mesorectal excision(TME)in patients with middle and low position local progressive stage rectal cancer.Method:From June 2018 to June 2021,80 patients with middle and low position local progressive stage rectal cancer were retrospectively selected from the Colorectal Surgery and Radiotherapy Department of the 940th Hospital of the PLA Joint Logistic Support Force.According to the different treatment methods,they were divided into control group and observation group,with 40 cases in each group.The control group was given the TME treatment,and the observation group was given the synchronous neoadjuvant radiotherapy and chemotherapy combined with TME treatment.The tumor markers,serum markers,defecation function before and after treatment,radical resection rate,anus preserving rate and clinical efficacy were compared between the two groups.Result:After treatment,the levels of carcinoembryonic antigen(CEA),carbohydrate antigen 242(CA242),carbohydrate antigen 19-9(CA19-9),fatty acid synthase(FAS)and tumor type M2 pyruvate kinase(Tu M2-PK)in the observation group were lower than those in the control group(P<0.05).After treatment,the low anterior resection syndrome scale(LARS)score of the anal preserving patients in observation group was lower than that of the anal preserving patients in control group(P<0.05).The radical resection rate and anus preserving rate in the observation group were higher than those in the control group(P<0.05).Three months after treatment,the total effective rate of the observation group was higher than that of the control group(P<0.05).Conclusion:Giving synchronous neoadjuvant radiotherapy and chemotherapy combined with TME for patients with middle and low position local progressive stage rectal cancer can reduce the levels of tumor and serum markers,improve their defecation function and anus preserving rate,and ensure the resection rate and clinical efficacy.

关 键 词：同步新辅助放化疗 TME 中低位局部进展期 直肠癌 肿瘤标志物 排便功能 临床疗效 

分 类 号：R735.37[医药卫生—肿瘤]