全程三维适形放疗同步口服希罗达治疗局部晚期及术后复发直肠癌的疗效分析

Effects of three dimensional conformal radiotherapy combined with xeloda for locally advanced rectal cancer and recurrent rectal cancer

目的:回顾性分析全程三维适形放疗同步口服希罗达治疗局部晚期及术后复发直肠癌的近期疗效及不良反应。方法:经病理证实的局部晚期直肠癌病人48例及术后复发的直肠癌43例共计91例,其中59例进行了全程3DCRT,并同时口服希罗达2周期化疗;另外32例仅行单纯3DCRT治疗。结果:近期疗效评价,3DCRT+希罗达同步治疗组与单纯3DCRT组的CR分别为17%(10/59)、15.6%(5/32);PR分别为72.9%(43/59)、53%(17/32),NC分别为5.1%(3/59)、12.5%(4/32);PD分别为5.1%(3/59)、18.9%(6/32),RR分别为89.8%、68.8%,疼痛缓解率分别为82.4%(48/59)、71.4%(23/32)。主要不良反应为骨髓抑制、胃肠道反应及放射性直肠炎、膀胱炎,对症处理后多能缓解。结论:全程三维适形放疗同步口服希罗达是治疗局部晚期及术后复发直肠癌安全有效的治疗方案。

Objective ：To retrospectively analyze the efficacy and safety of three dimensional conformal radiothera- py combined with xeloda for locally advanced rectal cancer and recurrent rectal cancer. Methods： Total of 91 pa- tients（ Forty- eight patients with locally advanced rectal cancer and forty -three patients with recurrent rectal canc- er） ,dividived into radiotherapy combined with xeloda （fifty -nine） , and radiotherapy alone （thity -two）. Xeloda was orally administered concurrently with radiotherapy for 2 cycles in escalating doses. Results： The complete re- sponse rate of combined group was 17% ,the part response rate was 79.2% ,and the overall response（ CR ＋ PR） rate was 89.8%. The complete response rates of alone radiotherapy group was 15.6% ,the part response rate was 53% , and overall response（ CR ＋ PR） rate was 68.8%. The pain alleviation rates were 82.4% and 71.4% in combined group and control group. The major side effects were bone marrow inhibition, gastrointestinal reaction, radiation procto- colitis and radiation cystitis. Conclusion： Three dimensional conformal radiotherapy combined with xeloda are effec- tive and less side effection in locally advanced rectal cancer and recurrent rectal cancer.