同步加量调强放疗技术在直肠癌术前同期放化疗的应用效果

Application effect of simultaneous integrated boost intensity modulated radiation therapy on preoperative concurrent radiotherapy and chemotherapy for rectal cancer

目的研究在直肠癌术前实施同期化疗应用同步加量调强放疗(SIB-IMRT)技术的临床应用效果及其安全性。方法选择我院2012年4月至2017年4月收治并随访60例接受直肠癌手术的患者,按照随机数字表法将其分为对照组和观察组,对照组实施常规调强放疗(R-IMRT),观察组实施SIB-IMRT,两组患者均接受药物化疗,比较两组患者临床疗效及其术后不良反应产生情况。结果两组患者术前检查,观察组患者中有6例达到完全缓解,对照组患者中有1例达到完全缓解,差异有统计学意义(P<0.05),观察组患者客观缓解率明显高于对照组,差异有统计学意义(P<0.05),观察组疾病控制率与对照组比较,差异无统计学意义(P>0.05)。观察组患者手术保肛率、肿瘤病理降期率及退缩率明显高于对照组,差异有统计学意义(P<0.05)。观察组患者在术后的无局部复发时间及无进展生存时间明显长于对照组,生活质量评分明显高于对照组,差异有统计学意义(P<0.05)。观察组患者不良反应发生率及严重程度与对照组比较,差异无统计学意义(P>0.05)。结论SIB-IMRT技术在直肠癌术前同期放化疗中获得了满意的临床效果,提升了患者治疗的有效性,延长了患者的无局部复发时间及无进展生存时间,且其不会增加患者的不良反应,能改善患者的生活质量。

Objective To investigate the clinical application effect and safety of simultaneous integrated boost intensity modulated radiation therapy(SIB-IMRT)on preoperative concurrent radiotherapy and chemotherapy for rectal cancer.Methods A total of 60 patients undergoing rectal cancer surgery admitted to our hospital and followed up from April 2012 to April 2017 were selected.They were divided into the control group and the observation group according to the random number table method.The control group was treated with regular modulated radiation therapy(R-IMRT),while the observation group was treated with simultaneous integrated boost intensity modulated radiation therapy(SIB-IMRT).Both groups of patients were treated with drug chemotherapy.The clinical efficacy and postoperative adverse reactions(ARs)of the two groups of patients were compared.Results Two groups of patients with preoperative examination,6 patients in the observation group achieved complete remission,1 patient in the control group achieved complete remission,the difference was statistically significant(P<0.05).The objective remission rate of the patients in the observation group was significantly higher than that in the control group,with statistically significant difference(P<0.05).There was no significant difference in disease control rate between the observation group and the control group(P>0.05).The anus-preserving rate in the observation group was significantly higher than that in the control group,with statistically significant difference(P<0.05).And the pathological decline rate and regression rate of tumor in the observation group were higher than those in the control group.The local recurrence-free time and progression-free survival time of the observation group were significantly longer than those of the control group,and the quality of life(QoL)score of the observation group was significantly higher than that of the control group,with statistically significant differences(P<0.05).The incidence and severity of ARs in patients of the observation group were similar to those in the control group,without statistically significant differences(P>0.05).Conclusion The SIB-IMRT technology has achieved satisfactory clinical results in preoperative concurrent radiotherapy and chemotherapy for rectal cancer,which improves the effectiveness of patients'treatment,prolongs the local recurrence-free time and progression-free survival time of patients withoutincreasing the ARs of patients,and can improve the QoL of patients.