三维适形放疗联合化疗治疗术后复发性直肠癌的临床研究

Clinical study of three dimensional-conformal radiation therapy combined with chemotherapy for recurrent rectal cancer

目的探讨三维适形放疗联合化疗治疗术后复发性直肠癌的临床疗效。方法28例术后复发性直肠癌采用常规放射治疗至40Gy,再予后程适形放疗加化疗。适形放疗25～30Gy,肿瘤总量65～70Gy;化疗第1天奥沙利铂130mg/m2,第1～5天亚叶酸钙100mg/m2,第1～5天5-氟尿嘧啶500mg/m2。结果患者有效率为82.1%;第1、2、3年生存率分别为82%、61%和32%,发生远处转移6例,远处转移率为21%;胃肠道反应、骨髓抑制、放射性直肠炎、放射性膀胱炎为主要副反应,多为Ⅰ、Ⅱ级。结论三维适形放疗联合化疗毒副反应小,可提高术后复发性直肠癌的生存率,改善其生存质量。

[Objective] To study the outcome of recurrent rectal cancer treated by three dimensional-conformal radiation therapy combined with chemotherapy. [Methods] 28 patients with recurrent rectal cancer received conventional radiotherapy plus 3D-CRT combined with chemotherapy. The prescription dose was 65-70 Gy. All patients were treated with oxaliplatin 130 mg/m^2, dl, combined with leueovorin 100 mg/m^2, all-5, fluorouraeil 500 mg/ m^2, dl 5- [Results] The overall response rates was 82.1%. The overall 1, 2, 3 year survival rates were 82%, 61%, 32%. 6 cases distantly metastasized and distant metastasis was 21%. The side effects were gastrointestinal reaction, bone marrow depression, radiation rectitis, radiation urocystitis, and their degree mainly varied from grade 1 to grade 2. [ Conclusion] Three-dimensional cordormal radiotherapy with chemotherapy is able to prolong the survival of patients with recurrent rectal carcinoma. In addition, the side effects is minor and can improve life quality.