中低位直肠癌术前超分割放疗联合FOLFIRI方案全身化疗的临床疗效观察

Clinical study of concurrent preoperative hyperfractionated radiotherapy with FOLFIRI in the treatment of mid-low rectal carcinoma

目的探讨中低位直肠癌术前超分割放疗联合化疗的可行性及其临床疗效观察。方法对68例中低位直肠癌患者进行回顾性研究,按放疗方法分为术前超分割放化疗组(A组)和常规分割放化疗组(B组)。A组:DT:30 Gy/10次/5 d,1～2周后手术;B组:DT:40 Gy/20次/5周,4周后手术。两组分别于放疗的第1天及第8天化疗2周期。结果 A、B组近期毒性反应及肿瘤降期率差异无统计学意义(P>0.05),手术切除率为100%。A组保肛率为79.4%,B组为85.3%,两者差异无统计学意义(P>0.05)。结论中低位直肠癌术前超分割放疗联合化疗是可行的,且疗效与常规放化疗相当,但在治疗时间上明显缩短,值得进一步研究。

Objective To evaluate the efficacy and feasibility of hyperfractionated radiotherapy with FOLFIRI in the treatment of mid-low rectal carcinoma. Methods A total of 68 patients with mid-low rectal carcinoma were enrolled, of which 34 patients in group A received concurrent preoperative hyperfraetionated radiotherapy with FOLFIRI and other 34 cases in group B were treated with concurrent preoperative eonventional fractionated radiotherapy with FOLFIRI.The total dose of radiotherapy was 30 Gy with 3 Gy fractions every time,two times every day（interval 6 h be- tween fraction） in group A. The radiotherapy lasted 5 days. Two cycles chemotherapy were given concurrently on days 1 and 8 with FOLFIRI. Surgery was performed in 1-2 weeks with TME. Patients in group B were treated with 40 Gy with 2 Gy fractions every time,one time every day,and chemotherapy is the same as group A. Then patients received operation after 4 weeks with TME. Results All patients completed the preoperative ehemoradiotherapy and surgery. There was no significant differenee （P 〉 0.05） in the acute toxic side effect and T and N downstaging. All patients were suffered resection. The sphincter preservation rate of group A and group B were 79.4% and 85.3%,and there was no significant difference （P 〉 0.05）. Conclusion It is feasible for concurrent preoperative hyperfraetionated radiotherapy with FOLFIRI in the treatment of mid-low rectal carcinoma,and the time of the treatment is obvious short, so it is ef- fective option for mid-low rectal carcinoma.