低位直肠癌腔内热疗加放疗的临床意义

Clinical value of Preoperative Endo cavitary Hyperthermia Combined with Radiotherapy in Low Rectal Cancer

目的探讨术前腔内热疗加放疗在低位直肠癌治疗中的临床价值。方法将2003~2010年121例低位直肠癌患者随机分为三组,其中A组51例患者接受术前腔内热疗加放疗,B组24例患者接受单纯放疗,C组46例患者未接受腔内热疗和放疗。对比三组患者手术保肛率、术后局部复发率、术后5年生存率。结果 121例患者全部行手术切除。保肛率比较：A组（33.33%）〉B组（29.17%）〉C组（4.35%）,A组和B组相比差异无统计学意义（P〉0.05）,A组和B组与C组相比差异均具统计学意义（P〈0.05）。术后局部复发率比较：A组（3.92%）〈B组（12.50%）〈C组（32.61%）,A组和B组相比差异无统计学意义（P〉0.05）,A组和B组与C组相比差异均具统计学意义（P〈0.05）。5年生存率比较：A组（74.51%）〉B组（70.83%）〉C组（52.17%）,A组和B组相比差异无统计学意义（P〉0.05）,A组和B组与C组相比差异均具统计学意义（P〈0.05）。结论低位直肠癌术前腔内热疗加放疗的新辅助治疗在提高保肛率、5年生存率和降低术后局部复发率方面具有积极意义。

Objective To investigate the clinical value and significance of preoperative endocavitary hyperthermia combined with radiotherapy in low rectal cancer. Methods Retrospective analysis the clinical data of 121 patients with low rectal cancer in 2003-2010, 51 cases who received preoperative radiotherapy combined with preoperative endocavitary hyperthermia were divided into Group A, and 24 patients who received preoperative radiotherapy were divided into Group B, 46 cases did not receive preoperative endocavitary hyperthermia and radiotherapy were divided into Groups C. Comparative analysis the postoperative anal sphincter preservation rate 、postoperative local recurrence rate、five-years survival rate in three groups. Results All 121 patients underwent surgical resection. Anal sphincter preservation rate comparison： Group A（33.33%）〉 Group B（29.17%）〉 Group C（4.35%）, Group A and Group B showed no statistically significant difference（P〉 0.05）, the differences of Group A and Group B compared to Group C were statistically significant（P 〈0.05）. Postoperative local recurrence rate comparison： Group A（3.92%） 〈Group B（12.50%） 〈Group C（32.61%）, Group A and Group B showed no statistically significant difference（P〉 0.05）, Group A and Group B compared with Group C differences were statistically significant（P 〈0.05）. Five-year survival rate： Group A（74.51%）〉 Group B（70.83%）〉 Group C（52.17%）, the differences of Group A and Group B were not significantly（P〉 0.05）, Group A and group B compared with group C differences were statistically significant（P 〈0.05）.Conclusion Neoadjuvant therapy of preoperative radiotherapy combined with preoperative endocavitary hyperthermia in Low rectal cancer has security and positive significance on improving the rate of anal preservation、five-years survival rate and reducing the postoperative local recurrence rate.