三维适形放疗联合化疗治疗晚期直肠癌的临床观察

Clinical observation of 3-dimensional conformal radiotherapy combined with chemotherapy for advanced rectal cancer

目的 探讨三维适形放射治疗（3DC RT）联合卡培他滨化疗治疗晚期直肠癌的临床疗效.方法 48例术后复发晚期直肠癌患者随机分为观察组24例和对照组24例.观察组采用3DCRT至总剂量64 ～66 Gy,放疗第1天开始口服卡培他滨1 650 mg/m2,连服2周停l周为1个周期,放疗结束后继续行2个周期化疗.对照组采用单纯3DCRT.结果 观察组1、2、3年生存率（分别为87.50％、66.67％、45.83％）均明显高于对照组（分别为62.50％、37.50％、25.00％,P＜0.05）,但近期疗效和毒副反应2组差异无统计学意义（P＞0.05）.结论 3DCRT联合化疗是治疗直肠癌术后复发的有效方法,能提高患者的近期生存率.

Objective To evaluate the efficacy of 3 -dimensional conformal radiotherapy （3DCRT） combined with chemotherapy for advanced rectal cancer. Methods 48 advanced rectal cancer patients with postoperative local recur- rence were randomly divided into treatment group （ n = 24） and control group （ n = 24）. All the patients in the two groups received 3DCRT to a total dose of 64 - 66 Gy. From the first day of 3DCRT the treatment group was given capetabine 1 650 mg/m2 orally for 2 weeks followed by 1 week rest period given as 3 week cycle. The patients in treatment group re ceived 2 more cycles of chemotherapy after radiotherapy. Results The I - , 2 - and 3 - year survival rates in the treat-ment group （87.50% , 66.67%, 45.83%, respectively） were significantly higher than in the control group （62.50%, 37.50% , 25.00% , respectively, P 〈 0.05 ）. The side effects were similar in the 2 groups （ P 〉 0.05 ）. Conclusion 3DCRT combined with chemotherapy can be considered as an effective and feasible approach for advanced rectal cancer and may significantly improve the survival rate.