三维适形放疗序贯替吉奥化疗治疗高龄局部晚期直肠癌患者的疗效观察

Clinical Observation of Three-dimensional Conformal Radiotherapy Combined with S-1 Sequen- tial Chemotherapy for the Treatment of Elderly Patients with Locally Advanced Rectal Cancer

【目的】评价三维适形放疗序贯替吉奥化疗高龄局部晚期直肠癌患者的临床疗效及毒副反应。【方法】对30例非手术的高龄局部晚期直肠癌患者予以三维适形放射治疗并序贯替吉奥胶囊（S-1）口服化疗4周期。三维适形放射治疗方案：90％～95％处方剂量线，每次3～4Gy，每周5次，总剂量36～40Gy，生物等效剂量46．8～50．4Gy。替吉奥化疗方案：40mg／m2，2次／日，连续给药4周，休息2周为1个周期。化疗4周期后行直肠镜等检查评价疗效，以后定期随访复查。【结果】完全缓解10例，部分缓解17例，稳定2例，进展1例，近期总有效率90．0％。1，2，3年生存率分别为1（）（）％、86．7％、63．3％。主毒副反应为下消化道反应，其中Ⅲ级反应2例。其余均为I～Ⅱ级。【结论】三维适形放疗序贯替吉奥化疗高龄局部晚期直肠癌患者的疗效好，毒副反应轻。

[Objective]To evaluate the clinical efficacy and side reactions of three-dimensional conformal radiotherapy combined with S-1 for elderly patients with locally advanced rectal cancer. [Methods]Thirty eld- erly patients with locally advanced rectal cancer receiving nonsurgical therapy were treated by three-dimensional conformal radiotherapy combined with S-1 sequential chemotherapy orally for 4 weeks. Three-dimensional con- formal radiotherapy scheme was 90 % -95 % prescribe dose 3-4Gy once for 5 times per week, the total dose of 36-40Gy and biological effective dose of 46.8-50.4Gy. S-1 scheme was -1 40mg/m2 twice a day for 4 successive weeks and rest for 2 week as a cycle. Colonoscopy and other examinations 4 weeks after chemother- apy were used for evaluating the efficacy. All patients were followed up and reexamined regularly. [Results] Among all patients, 10 patients were complete remission, and 17 patients were partial remission, and 2 pa- tients were stable, and 1 patient was progressive, and the short-term effective rate was 90.00%. The 1, 2 and 3-year survival rate was 100%, 86.7% and 63.3%0, respectively. The main side reaction was lower digestive tract response. Grade III toxicities occurred in 2 patients, and grade I^II toxicities occurred in other patients. [Conclusion]Three-dimensional conformal radiotherapy combined with S-1 sequential chemotherapy for the treatment of elderly patients with locally advanced rectal cancer has good effect with mild side reactions.