局部晚期低位直肠癌术前不同放疗模式疗效观察

Effect of different preoperative radiotherapy models for locally advanced low rectal cancer

目的:探讨术前不同放疗模式对局部晚期低位直肠癌的治疗意义。方法:40例局部晚期低位直肠癌患者,其中23例采用术前同步放化疗,放疗方式采用盆腔外照射,DT 50戈瑞/25次,化疗方案为卡培他滨750毫克/米2,每日两次口服,间隔12小时,连用5周,照射结束后4周手术。另17例患者采用短程低分割放疗方案,DT 25戈瑞/5次/5天,照射结束后1周左右手术。结果:术前同步放化疗组和术前短程低分割组有效率分别为78.2%和58.8%,保肛率分别为73.9%和44.4%,病理完全消失率分别为13.0%和0,3年生存率分别为73.9%和58.8%,P<0.05,均有统计学差异。术后吻合口瘘发生率分别为4.3%和4.1%,P>0.05无统计学差异。结论:局部晚期低位直肠癌术前同步放化疗临床疗效好,生存质量高,为优先选择方案。

Objective：To observe the effect of different preoperative radiotherapy for locally advanced rectal cancer. Methods： Of 40 cases,23 were treated with concurrent radiochemotherapy,using pelvic irradiation,DT 50Gy/25times, chemotherapy ： capecitabine 750mg/m2,twice a day orally,interval of 12 hours,last 5 weeks,after 4 weeks operation was performed .Other 17 patients were treated with radiotherapy of short-range low segmentation schemes,DT 25Gy/5times/5 days,after 1 week operation was performed. Results： Preoperative concurrent radiochemotherapy group and separate groups of preoperative short-range efficiency rates were 78.2% and 58.8%,sphincter preservation rates were 73.9% and 44.4%,pathological disappearance rates were 13.0% and 0,3-year survival rates were 73.9% and 58.8%,P0.05. The incidence of postoperative anastomotic leakage was 4.3% and 4.1%,P0.05. Congclusion： The clinical effect of preoperative concurrent radiochemotherapy for locally advanced low rectal cancer was good with high quality of life and a priority option.