适形调强放疗联合口服卡培他滨化疗治疗局部进展期直肠癌术后患者的临床效果

Clinical efficacy of conformal intensity modulated radiation therapy with oral capecitabine chemotherapy in patients with advanced rectal cancer after surgery

目的探讨适形调强放疗联合口服卡培他滨化疗治疗局部进展期直肠癌术后患者的临床效果。方法选取2013年4月~2015年5月厦门市肿瘤医院放疗科收治的87例局部进展期接受直肠癌根治性手术患者作为研究对象,将其随机分为对照组(42例)和实验组(45例)。对照组患者采用单纯调强放疗,照射剂量45 Gy,总照射次数为28次,每周5次;实验组患者在此基础上给予同步口服卡培他滨(825 mg/m2)化疗,每周一至周五与放疗同步。比较两组患者的总生存率、无瘤生存率、远处转移率、局部复发率及不良反应发生情况。结果两组患者的3年总生存率、无瘤生存率比较,差异无统计学意义(P>0.05);实验组患者的远处转移率、局部复发率低于对照组,差异有统计学意义(P<0.05);实验组患者的手足综合征、骨髓抑制总发生率明显高于对照组,差异有统计学意义(P<0.05)。结论适形调强放疗联合口服卡培他滨化疗治疗局部进展期直肠癌术后患者的临床效果较好,3年远处转移率及局部复发率低于单纯放疗,急性不良反应发生率有所升高,但均可以耐受。

Objective To explore the clinical efficacy of conformal intensity modulated radiation therapy with oral capecitabine chemotherapy in patients with advanced rectal cancer after surgery. Methods Eighty-seven with advanced rectal cancer patients after radical surgery in Department of Radiation Oncology of Xiamen Cancer Hospital from April2013 to May 2015 were selected as subjects, and were randomly divided into the control group（n=42） and the experiment group（n=45）. The control group was treated by simple intensity modulated radiation therapy with total dose of 45 Gy,5 times per week and 28 times in total. On the basis of it, the experiment group received capeticitabine radiochemo therapy（825 mg/m2）, form Monday to Friady. The overall survival rate, tumor-free survival rate, distant metastasis rate,local recurrence rate and adverse reaction were compared between the two groups. Results The 3-year overall survival rate and the tumor-free survival rate of the two groups were compared, and the differences were not statistically significant（P〉0.05）. The distant metastasis rate and local recurrence rate were lower in the experimental group than those in the control group, the differences were statistically significant（P〈0.05）. The incidence of hand-foot syndrome and bone marrow suppression in the experment goup were higher than those in the control group, the differences were statistically significant（P〈0.05）. Conclusion Conforual intestity modulated radiotherapy with oral capecitabine has better effets and3-year destant metastasis rateand local recurrence rate on advanced rectal cancer were lower,though the incidences of acute adverse reactions were increased at some extent which were tolerable.