同步或序贯放化疗治疗进展期直肠癌的疗效分析

CLINICAL STUDY OF CONCURRENT OR SEQUENT CHEMORADIOTHERAPY FOR ADVANCED RECTAL CANCER

目的 :采用同步或序贯放化疗的模式作为进展期直肠癌根治性手术后的辅助治疗 ,并分析评价治疗疗效和毒副作用。方法 :36例 期患者和 5 6例 期患者随机分为 A 组、 B组和 A 组、 B组 ,其中 A 和 A 接受序贯放化疗模式 (DT4 5 Gy/ 2 5次 ,共 35天后休息 2周～ 4周接受L V+5 - Fu4疗程 ) , B和 B接受同步放化疗模式 (DT4 5 Gy/ 2 5次 ,共 35天同步 L V+5 - Fu1疗程 ,休息 1周～ 2周后接受 L V+5 - Fu3疗程 )。结果 :两种治疗模式对 期患者的治疗疗效无明显差异。对于 期患者 ,除 1年总生存率无差异外 ,同步治疗模式明显延长了 1年、3年无进展生存期和 3年总生存率。同步治疗模式的毒副作用虽有一定提高 ,但无明显差异 ,大部分均可耐受。结论 :同步放化疗作为 期直肠癌根治性手术后较为理想的辅助治疗模式 ,明显改善生存质量 ,延长长期生存期。

Objective:To analyze the results of concurrent or sequent chemoradiotherapy for advanced (stage Ⅱ and Ⅲ) rectal cancer.Methods:36 cases were in stage Ⅱ and 56 cases were in stage Ⅲ of rectal cancer,and randomized into four groups after curative resection.In group Ⅱ a (16 cases) and Ⅲ a (27 cases) sequent chemoradiotherapy was given,and in group Ⅱ b (20 cases) and Ⅲ b (29 cases) concurrent chemoradiotherapy was given.Results:The results of treatment showed no singnificant difference in patients of stage Ⅱ,on the other hand,to those who are in stage Ⅲ,the one year survival rate in the two groups (Ⅲ a Vs Ⅲ b) are 77.8 % VS 82.8 % ( P >0.05) and 38.1 % Vs 75 % ( P <0.05).The one year and three year disease free survival rate were 44.4 % Vs 75.9 % ( P <0.05) and 23.8 % Vs 58.3 % ( P <0.05).Conclusion:These results demonstrated that concurrent chemoradiotherapy is obviously better than sequent chemoradiotherapy to those patients with rectal cancer of stage Ⅲ.