实用肿瘤学杂志 ›› 2011, Vol. 25 ›› Issue (6): 520-524.doi: 10.3969/j.issn.1002-3070.2011.06.006

• 论著 • 上一篇    下一篇

术前同期放化疗对局部晚期低位直肠癌患者保肛率及根切率的影响

葛立本, 姚月良, 闫文星, 陈玉丙   

  1. 吉林大学第二医院放疗科(长春 130021)
  • 收稿日期:2011-08-16 出版日期:2011-12-28 发布日期:2014-12-02
  • 通讯作者: 陈玉丙,E-mail:yb0707@163.com
  • 作者简介:葛立本,男,(1962-),硕士,从事肿瘤的放射治疗和化学治疗研究
  • 基金资助:
    吉林省科技发展计划项目(200705258)

Affect of neoadjuvant chemoradiontherapy to the resection rates and the sphincter preserving rates of patients with locally advanced lower rectal cancer

GE Liben,YAO Yueliang,YAN Wenxing,CHEN Yubing   

  1. 1.Department of Radiation Onclolgy,The Second Affiliated Hospital of Jilin University,Changchun 130021
  • Received:2011-08-16 Online:2011-12-28 Published:2014-12-02

摘要: 目的 观察术前同期放化疗对局部晚期低位直肠癌患者手术治疗保肛率及根切率的影响。方法 回顾性研究2006年1月—2010年12月间入院的局部晚期低位直肠癌患者共64例,按治疗手段分为术前同期放化疗A组(n=34)和单纯手术切除B组(n=30)。术前同期放化疗组采用三维适形放疗,同步行奥沙利铂(L-OHP)+5-氟尿嘧啶(5-Fu)+亚叶酸钙(CF)方案化疗,放射总剂量为50 Gy,每次2 Gy,每周5次。放疗的第1天同步行化疗,手术于放疗结束后4~5周进行,手术按直肠全系膜切除(TME)原则进行。结果 全部患者均完成治疗,同期放化疗组放化疗结束后肿块均有不同程度缩小、活动度增加,总缓解率为64.7%,手术切除率91.2%,保肛率为79.4%,单纯手术组手术切除率66.7%,保肛率为43.3%。结论 术前应用同期放化疗可提高低位直肠癌患者的根切率及保肛率,同时改善了患者的生活质量。

Abstract: Objective To investigate the effect of neoadjuvant chemoradiontherapy to the resection rates and the sphincter preserving rates of patients with locally advanced lower rectal cancer.Methods A retrospective analysis was performed on the clinical data of 64 cases of low rectal cancer from January 2006 to Dectember 2010.All patients were divided into two groups A(n=34)and B(n=30),according to the way of treatment.Preoperative concurrent chemoradiotherapy group is received three-dimensional conformal radiotherapy.The accumulated dose of preoperative radiotherapy was 50Gy,2Gy per day,5 days one week and startes to walk scheme chemotherapy(Oxaliplatin +CF+5-FU)at the first week of the radiotherapy,Operation in 4~5 week after radiotherapy;group B(n=30),just a surgical operation.In all the patients,surgery was carried out according to the principle of TME.Results All patients completed the planned treatment.The tumors became smaller and more movable.The total remission rate is 64.7%.The resection rates of the two groups is 91.2 % and 66.7 %,respectively.The sphincter preserving rates were 79.4 % and 43.3%,respectively.Conclusion Peroperative concurrent chemoradiontherapy can improve the resection rates and the sphincter preserving rates so as that the quality of life in patients with locally advanced lower rectal cancer is improved.

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