术前辅助治疗在中低位直肠癌治疗中的价值

The value of preoperative adjuvant therapy on middle and low rectal cancer

目的探讨术前放化疗在中低位直肠癌中的价值。方法对91例中低位直肠癌患者的临床资料进行回顾性研究,按治疗手段分为术前辅助放化疗组(A组,n=24)与术后辅助放化疗组(B组,n=67)。比较术前辅助放化疗在中低位直肠癌中的优势。结果 A组和B组患者的保肛门率分别为62.5%和35.8%(P=0.023<0.05);放化疗中损伤达2级以上的发生率分别为25%和49.5%;局部复发率分别为4.2%和22.4%(P=0.044<0.05);5年生存率分别为66.7%和58.6%(P=0.588)。结论中低位直肠癌术前放化疗能提高保肛率,降低放化疗反应,并在一定意义上改善手术切除率和减少局部复发。

Objective To discuss the value of preoperative radiotherapy and chemotherapy on middle and low rectal cancer.Methods 91 low colorectal cancer patients were retrospectively studied.According to the treatments,the patients were divided into preoperative adjuant radiation and chemotherapy group（group A,n=24） and postoperative adjuvant radiation and chemotherapy group（group B,n=67）.Through the comparison between the two groups,the advantage of preoperative adjuant radiation and chemotherapy was observed in low colorectal cancer.Results Group A and group B of patients with the anus rate were 62.5% and 35.8%,respectively（P=0.023）.The incidence of injuring in the radiation and chemotherapy to above 2 class were 25% and 49.5% respectively.Local recurrence rate were 4.2% and 22.4%,respectively（P=0.044）;5 year survival rates were 66.7% and 58.6% respectively（P=0.588）.Conclusion Preoperative radiation and chemotherapy in colorectal cancer can improve the rate of keeping anus,reduce concurrent chemoradiation reaction,improve operation excision rate and reduce local recurrence to a certain extent.