术前加量调强放疗联合卡培他滨对Ⅱ、Ⅲ期直肠癌的临床疗效

Clinical effect of preoperative intensity modulated radiation therapy combined with capecitabine on patients with stage Ⅱ and Ⅲ rectal cancer

目的:探讨术前加量调强放疗联合卡培他滨对Ⅱ、Ⅲ期直肠癌的临床疗效。方法:选择124例Ⅱ、Ⅲ期直肠癌患者为研究对象,采用随机数字表法分为对照组和观察组,各62例。对照组在全直肠系膜切除术(TME)之前接受加量调强放疗,观察组在TME之前接受加量调强放疗联合卡培他滨化疗。评估放化疗后两组的近期有效率,记录放化疗过程中毒副作用和不良反应的发生情况,比较放化疗前和TME前两组患者的肿瘤TNM分期变化情况。结果:观察组治疗有效率显著高于对照组(P<0.05);两组并发症发生率差异无统计学意义(P>0.05);观察组T降期率和N降期率都显著高于对照组(均P<0.05)。结论:直肠癌术前加量调强放疗联合卡培他滨化疗效果显著,不增加放疗反应的毒副反应,安全性好,值得临床推广。

Objective： To investigate the effect of preoperative intensity modulated radiation therapy combined with capecitabine on patients with stageⅡand Ⅲ rectal cancer. Method： One hundred and twenty-four cases of rectal cancer were randomly divided into two groups： the control group and the experimental group. Intensity-modulated radiotherapy was given to the control group prior to total mesorectal excision（ TME）. Intensity-modulated radiotherapy combined with capecitabine was given to the experimental group before the TME. Toxic side effects and adverse reaction were recorded during the course of radiotherapy and chemotherapy so as to evaluate the efficiency of the two groups. The changes of TNM staging of the two groups before and after radiotherapy and chemotherapy were compared. Results： The treatment efficiency of the experimental group was significantly higher than that of the control group（ P〈0. 05）. There was no significant difference in the incidence of adverse reactions between the two groups（ P〉0. 05）. In the experimental group,the rate of T and the rate of N reduction were significantly higher than those in the control group（ all P〈0. 05）. Conclusion： Intensity modulated radiation therapy combined with capecitabine for patients with rectal cancer has a significant effect,it doesn＇ t increase the toxicity and side effects of radiotherapy. It is safe and worthy of clinical application.