容积旋转调强放疗联合化疗治疗直肠癌术后局部复发疗效观察

Observation of therapeutic effect of Postoperative local recurrence rectal cancer treated by combining VMRT and chemotherapy

目的：探讨容积旋转调强放疗（VMRT）联合化疗治疗直肠癌术后复发的价值.方法：江苏大学附属人民医院直肠癌根治性切除术后复发患者28例,均接受VMRT（2 Cy/次,5次/周,总剂量62~66 Cy,6~7周完成）,同时进行化疗（5-FU、CF和奥沙利铂）.经随访观察,予回顾性分析.结果：治疗总有效率（CR＋PR）为89.2%（25/28）,l、2、3年生存率分别为76.5%、52.3%、32.0%;1、2、3年无进展生存率分别为75.1%、53.2%、29.4%.急性放射反应主要是急性放射性肠炎和骨髓抑制,多为1、2级.结论：VMRT结合化疗可提高术后局部复发直肠癌的总生存率和无进展生存率,并能减少放射治疗反应.

AIM： To evaluate the value of postoperative local recurrence rectal cancer treated by combining volume of rotating intensity medulated radiotherapy（ VMRT） and chemotherapy.METHODS： Twenty-eight patients with postoperative local recurrence rectal cancer were treated by combining VMRT（ 2 and Cy /time,5 times / week,DT 62-66 Gy,5 ~ 6 weeks） and chemotherapy（ 5-Fu,CF and Oxaliplatin）. After following up and observing,we made a retrospective analysis. RESULTS： The total treatment efficacy（ CR ＋ PR） was 89. 2%（ 25 / 28）; 1,2 and 3years progression-free survival rates were 76.5%,52.3%,32.0%.1,2 and 3 years overall survival rates were 75. 1%,53. 2% and29.4%,respectively. Acute radiation side effects included radiatiori restitis and leukopenia were observed,and its degree varied mainly from Grade l to Grade 2. CONCLUSION： VMRT therapy combined with chemothcrapy for post-operative local recurrence rectal cancer can improve local control,survival rates and reduce acute radiation side effects.