新辅助同步放化疗联合手术治疗Ⅱ~Ⅲ期直肠癌的临床效果

Clinical effect of neoadjuvant concurrent chemoradiotherapy combined with surgery in the treatment of stageⅡ-Ⅲrectal cancer

目的探讨新辅助同步放化疗联合手术治疗Ⅱ~Ⅲ期直肠癌的临床效果。方法选取2017年3月至2021年3月新余市人民医院收治的92例Ⅱ~Ⅲ期直肠癌患者作为研究对象,采用随机摸球法将其分为观察组(n=46)和对照组(n=46)。对照组患者采用手术联合术后同步放化疗、术后化疗,观察组患者采用新辅助放化疗联合手术、术后化疗。比较两组患者的临床疗效、急性毒性反应发生率、保肛率、并发症发生率、局部复发率及总生存率。结果观察组患者的疾病控制率(DCR)高于对照组,差异有统计学意义(P<0.05);观察组患者的急性毒性反应发生率低于对照组,差异有统计学意义(P<0.05);观察组患者的保肛率高于对照组,差异有统计学意义(P<0.05);两组患者的并发症总发生率比较,差异无统计学意义(P>0.05);观察组患者的1、3、5年复发率低于对照组,1、3、5年总生存率高于对照组,差异有统计学意义(P<0.05)。结论新辅助同步放化疗联合手术方式治疗Ⅱ~Ⅲ期直肠癌患者能够提高临床疗效,降低急性毒性反应发生率、局部复发率,避免增加并发症发生率,促进保肛率、总生存率的提高。

Objective To investigate the clinical effect of neoadjuvant concurrent chemoradiotherapy combined with surgery in the treatment of stageⅡ-Ⅲrectal cancer.Methods A total of 92 patients with stageⅡ-Ⅲrectal cancer admitted to Xinyu People′s Hospital from March 2017 to March 2021 were selected as the study subjects,and they were divided into the observation group(n=46)and the control group(n=46)by random ball-touching method.The control group was received surgery combined with postoperative concurrent chemoradiotherapy and postoperative chemotherapy,while the observation group was received neoadjuvant concurrent chemoradiotherapy combined with surgery and postoperative chemotherapy.The clinical efficacy,the incidence of acute toxic reactions,anal the retention rate,the incidence of complications,the local recurrence rate and the overall survival rate were compared between the two groups.Results The disease control rate(DCR)in the observation group was higher than that in the control group,the difference was statistically significant(P<0.05).The incidence of acute toxicity in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).The anal retention rate in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the total incidence of complications between the two groups(P>0.05).The recurrence rate at 1,3,5 years in the observation group were lower than those in the control group,and the overall survival rate at 1,3,5 years in the observation group were higher than those in the control group,with statistical significance(P<0.05).Conclusion Neoadjuvant concurrent chemoradiotherapy combined with surgeryin the treatment of stageⅡ-Ⅲrectal cancer can improve the clinical efficacy,reduce the incidence of acute toxic reactions and the local recurrence,avoid increasing the incidence of complications,and promote the improvement of anal retention rate and overall survival rate.