联合化疗同步调强放疗治疗局部晚期或复发性直肠癌的临床研究

Clincial study of locally advanced or postoperative local recurrence rectal cancer treated by combining intensity-modulated radiotherapy and chemotherapy

目的探讨联合化疗同步调强放疗治疗局部晚期或复发性直肠癌的疗效和安全性。方法将2010年2月至2013年2月临床确诊的局部晚期或复发性直肠癌患者73例,随机分成治疗组38例采用雷替曲塞+奥沙利铂治疗,对照组35例采用氟尿嘧啶+奥沙利铂治疗。两组均给调强放疗2 Gy/次,5次/周,总剂量50~54 Gy,5~6周完成,对比分析其临床治疗效果及不良反应。结果治疗组有效率60.5%(23/38),对照组有效率68.8%(24/35),差异无统计学意义(P>0.05)。两组不良反应差异无统计学意义(P>0.05)。结论雷替曲塞+奥沙利铂同步调强放疗治疗局部晚期或复发性直肠癌与氟尿嘧啶+奥沙利铂同步调强放疗的疗效和不良反应具有相当性。

Objective To evaluate the therapeutic efficacy and safety of combining intensity -modulated radiotherapy and chemothera-py in treating locally advanced or postoperative local recurrence rectal cancer .Methods From Feb.2010 to Feb.2013,73 patients with post-operative local recurrence rectal cancer were randomized into two groups ,namely treatment group which received raltitrexed combined with ox-aliplatin and control group which received fluorouracil combined with oxaliplatin .Both groups were treated by IMRT (2 Gy/F,5 times/week, DT 50~54 Gy,5~6 week) combined with chemotherapy (TOMOX or FOLFOX4).After following up and observing,the clinical therapeutic effect and adverse reactions were compared and analysed .Results The treatment efficacy ( CR+PR) of treatment group and control group was 60.5%(23/38) and 68.8%(24/35),respectively,and there was no significant statistical difference (P>0.05).Conclusion Intensity modulated radiation therapy combined with chemotherapy for postoperative local recurrence rectal cancer can improve the local control ,which is safe and effective .