三维适形放疗联合卡培他滨化疗治疗中晚期直肠癌术后患者的临床疗效及安全性研究

Therapeutic effects and safety of 3DCRT combined with capecitabine on advanced rectal cancer

目的探究三维适形放疗（3DCRT）联合卡培他滨化疗治疗Ⅱ~Ⅲ期直肠癌术后患者的临床疗效及安全性。方法收集2008年11月至2011年11月接受Ⅱ、Ⅲ期直肠癌根治术的50例患者进行回顾性分析研究,根据术后的治疗方式分为单纯放疗组（仅3DCRT处理,n=18）和同步放化组（3DCRT同步卡培他滨化疗,n=32）,比较2组患者的临床疗效、生存状态及不良反应的发生情况。结果同步放化组的3年总生存率、无病生存率及远处转移率与单纯放疗组比较,差异均无统计学意义（P〉0.05）。同步放化组的局部复发率低于单纯放疗组,差异有统计学意义（P〈0.05）。同步放化组手足综合征、骨髓抑制和腹泻的发生率均显著高于单纯放疗组（P〈0.05）;而2组泌尿生殖道反应和呕吐的发生率比较,差异均无统计学意义（P〉0.05）。结论 3DCRT联合卡培他滨化疗治疗Ⅱ~Ⅲ期直肠癌根治术后患者的临床疗效较好,局部复发率低于单纯放疗,急性不良反应的发生率有所升高,但均可以耐受。

To investigate the therapeutic effects and safety of three dimensional conformal radiation therapy（ 3DCRT） combined with capecitabine chemotherapy on rectal cancer at stage Ⅱ and Ⅲ. Methods The data about50 patients with rectal cancer at stage Ⅱ and Ⅲ who underwent radical resection of rectal carcinoma in Department of Oncology of our hospital from November 2008 to November 2011 were retrospectively analyzed. According to the therapeutic way after operation,these patients were divided into simple radiotherapy group（ 3DCRT only,n = 18） and synchronization chemoradiotherapy group（ 3DCRT ＋ capecitabine,n = 32）. The therapeutic effects,patient＇s survival state and incidence of adverse reactions were observed and compared between the two groups. Results There were no significant differences in 3-year overall survival rate（ 90. 6% vs 72. 2%,P〉0. 05） and the disease free survival rate（ 75. 0% vs 61. 1%,P〉0. 05）between two groups. The local recurrence rates in synchronization chemoradiotherapy group were significantly lower than those in simple radiotherapy group（ P〈 0. 05）. The incidences of hand-foot syndrome,bone marrow depression and diarrhea in synchronization chemoradiotherapy group were significantly higher than those in simple radiotherapy group（ P〈0. 05）.However there were no significant differences in the incidences of genitourinary tract reaction and vomit between two groups（ P〉0. 05）. Conclusion 3DCRT combined with capecitabine has better therapeutic effects and lower local recurrence rates in treatment of rectal cancer at stage Ⅱ and Ⅲ,though the incidences of acute adverse reactions are increased at some extent,which are tolerable.