手术加放疗对直肠癌术后局部复发病人生存的影响

目的探讨手术加放射性粒子近距离放疗对直肠癌术后局部复发病人生存的影响。方法回顾性分析43例直肠癌局部复发病人，其中32例行手术加放射性粒子近距离放疗，11例行姑息性放疗、化疗，对比两组病人的生存情况。结果直肠癌病人在术后30个月内复发率迅速上升，中位复发时间11个月。经充分术前评估后，手术切除率为27/32，其中根治性切除17例、姑息性切除10例、未切除5例，同时在术中植入放射性125I粒子进行近距离放疗，该组病人术后平均生存时间（27.7±8.9）个月，5年生存率34.4%，对照组分别为（13.4±5.6）个月和9.1%。结论直肠癌局部复发病人采取手术同时术中植入放射性125I粒子进行近距离放疗可明显改善病人生存状况。

Objective To explore the influence of surgery combining the radioactive seed brachytherapy on the survival of local recurrence of rectal cancer patients. Methods Retrospective analysis of 43 cases of rectal cancer patients with local recurrence,32 routine surgery and radioactive seed brachytherapy,11 palliative radiotherapy,chemotherapy was applied and the survival of two groups of patients was compared. Results For Rectal cancer of 30 months postoperatively,the recurrence rate rapidly increased,the median time to recurrence was 11 months,after adequate preoperative assessment,surgical resection was 27/32,of which 17 cases of radicalresection,palliative resection in 10cases,not the removal of the five cases, surgery125iseed implantation brachytherapy,the groupof patients the mean survival time（27.7±8.9）months,the 5–year survival rate was 34.4%,while the control group were（13.4±5.6）months and 9.1%. Conclusions Intraoperative 125i seed implantation as brachytherapy for local recurrence for rectal cancer patients can significantly improve patient’s survival.