直肠癌术前调强适形放疗与常规放疗的疗效比较

Therapeutic effect comparsion of preoperative intensity modulated radiation therapy and routine radiotherapy in the radiotherapy of rectal cancer

目的：探讨直肠癌调强适形放射治疗的可行性及优势。方法选取2007年6月-2014年12月在本院治疗的80例行放射治疗的直肠癌患者作为研究对象，随机分成两组，各40例。观察组行调强适形放射治疗，放疗剂量为50 Gy；对照组行常规放射治疗，放疗剂量为46-48 Gy，比较两组的治疗效果、术后并发症和早期不良反应发生率。结果两组的治疗效果比较，差异无统计学意义（P〉0.05）。观察组的不良反应发生率为52.5%，多为Ⅰ-Ⅱ级不良反应，Ⅲ级以上不良反应发生率为2.5%。观察组的直肠反应发生率为25.0%，显著低于对照组的80.0%，差异有统计学意义（P〈0.05）。观察组的生殖器反应发生率为37.5%，显著低于对照组的52.5%，差异有统计学意义（P〈0.05）。观察组的保肛率为70%，显著高于对照组的25%，差异有统计学意义（P〈0.05）。结论调强适形放射治疗能够提高肛门括〈肌的保留机会，减少治疗的毒性反应，更好地保护直肠周边邻近的正常组织器官。

Objective To explore the feasibility and advantage of intensity modulated radiation therapy in the radio-therapy of rectal cancer. Methods 80 patients with rectal cancer underwent radiotherapy from June 2007 to December 2014 in our hospital were selected and randomly divided into two groups,40 cases in each group.The observation group was treated with intensity modulated radiation therapy,radiotherapy dose was 50 Gy.The control group was treated with routine radiotherapy,radiotherapy dose was 46-48 Gy.The therapeutic effect,postoperative complication and the inci-dence rate of adverse reaction in early stage in two groups was compared respectively. Results The therapeutic effect betwwen two groups was compared,with no statistical difference （P〉0.05）.The incidence rate of adverse reaction in ob-servation group was 52.5%,much asⅠ-II grade adverse reaction,the incidence ofⅢ grade adverse reaction was 2.5%. The incidence rate of rectal reaction in the observation group was 25.0%,which was lower than 80.0% in the control group,with statistical difference （P〈0.05）.The incidence rate of genital reaction in the observation group was 37.5%, which was lower than 52.5% in the control group,with statistical difference（P〈0.05）.The rate of anal preservation in the observation group was 70%,which was higher than 25%in the control group,with statistical difference（P〈0.05）. Conclu-sion Intensity modulated radiation therapy can improve the retention opportunity of anal sphincter,reduce toxicity reac-tion,which can better protect the adjacent normal tissues.