中晚期直肠癌患者术前卡培他滨联合不同放疗的疗效研究

Clinical research of pre-operative capecitabine combined with different radiotherapeutic regimens for median and advanced rectal carcinoma

目的探讨中晚期直肠癌患者腹腔镜手术前给予卡培他滨联合不同大分割放疗（普通、三维适形）的疗效及不良反应。方法将2011年2月至2012年12月经病理检查证实为中低位局部进展期直肠癌患者61例随机分为普通放疗组（30例）及三维适形放疗组（31例）,在同步卡培他滨化疗后6～8周行腹腔镜手术治疗。结果三维适形放疗组患者胃肠道反应、手足综合征和骨髓抑制等不良反应较普通放疗组明显减少,差异均有统计学意义（P=0.000）。两组患者术后并发症发生率和生存率比较,差异均无统计学意义（P＞0.05）。结论中晚期直肠癌患者腹腔镜手术前给予卡培他滨联合三维适形大分割放疗较普通大分割放疗能降低不良反应发生率,可作为局部晚期直肠癌的治疗方案。

Objective To explore the efficacy and untoward effect of pre-operative capecitabine combined with difference hypofractionated radiotherapeutic regimens [general radiotherapy（GRT） and three dimensional conformal radiotherapy（3DCRT）] in treating median and advanced rectal carcinoma. Methods Sixty-one patients,who were confirmed to locally advanced rectal carcinoma by pathological examination from February 2011 to December 2012,were randomly divided into GRT group（n=30） and 3DCRT group（n=31）,and the laparoscopic surgery was performed after 6-8 weeks of concurrent capecitabine chemotherapy. Results The untoward effects of gastrointestinal reaction,hand-foot syndrome,myelosuppression and so on in the3 DCRT group were reduced more significantly than those in the GRT group（P=0.000）. The difference between the two groups on postoperative complications and survival rate had no statistical significance（P〉0.05）. Conclusion The application of capecitabine combined with three dimensional conformal hypofractionated radiotherapy can reduce the occurrence rate of untoward effect in treating median and advance rectal carcinoma,and it can be used as a treatment regimen for local advanced rectal carcinoma.