早期低位直肠癌局部切除术后辅助放疗的效果

Effect of Adjuvant Radiotherapy Following Local Resection on Early Stage Low Rectal Cancer

目的:探讨早期低位直肠癌局部切除术后辅助放疗的安全性及其对患者血清CA199(carbohydrate antigen 199)表达、排尿功能及生存期的影响。方法:选择早期低位直肠癌患者120例。根据随机数字表法,将其分为治疗组和对照组,每组60例。两组均给予低位直肠癌局部切除术。治疗组术后进行放疗,疗程为5周。结果:两组治疗期间的不良反应以骨髓抑制、胃肠道反应、神经毒性为主,组间差异无统计学意义。两组治疗后的血清CA199浓度均明显低于治疗前(P<0.05),治疗组治疗后血清CA199浓度明显低于对照组(P<0.05);治疗组治疗后的排尿功能明显优于对照组(P<0.05)。所有患者随访至2015年7月,治疗组的中位生存期[(27.63±2.13)个月]与中位无进展生存期[(21.23±1.98)个月]均明显高于对照组[分别为(21.94±2.89)个月、(18.81±2.11)个月],差异均有统计学意义(P<0.05)。结论:早期低位直肠癌局部切除术后辅助放疗的安全性较好,能降低血清CA199的表达水平、促进排尿功能的恢复及延长患者的生存时间。

Objective：To investigate the safety of adjuvant radiotherapy following local resection for early stage low rectal cancer and its effect on patients＇ serum CA199 expression,urinary function,and survival time.Methods：A total of 120 patients with early stage low rectal cancer were enrolled.By random number table method,they were divided into the treatment group and the control group,with 60 patients in each group.Local resection was given for low rectal cancer in two groups.Postoperative radiotherapy was conducted in the treatment group for a period of five weeks.Results： The main adverse reactions in two groups during the treatment were bone marrow suppression,gastrointestinal reactions,neurotoxicity,and there was no statistically significant difference between the two groups.The serum CA199 expression in both groups after treatment was significantly lower than that before treatment（P〈0.05）.The expression of serum CA199 in the treatment group after treatment was also significantly lower than that in the control group（P〈0.05）.The urinary function in the treatment group after treatment was significantly superior to that in the control group,and the difference was statistically significant（P〈0.05）.All patients were followed up till July 2015.The median survival time[（27.63±2.13）months]and the median progression-free survival[（21.23±1.98）months]in the treatment group were significantly higher than those in the control group[（21.94±2.89）months and（18.81±2.11）months],and the differences were statistically significant（P〈0.05）.Conclusions：The adjuvant radiotherapy following local resection is safe for the early stage low rectal cancer.It can reduce the serum CA199 expression,promote the recovery of urinary function and prolong the survival time of patients.