摘要
目的 探讨Miles术后同步放化疗对改善Ⅲ期低位直肠癌患者预后的价值.方法 对2002-2003年行Miles术的132例Ⅲ期直肠癌患者的临床资料进行回顾性分析.根据患者意愿分为术后同步放化疗组（78例）和单纯化疗组（54例）.采用奥沙利铂加亚叶酸钙加氟尿嘧啶进行化疗 放疗方案为15MVX线,2 Gy/次,5次/周,总剂量50 Gy 与第1个疗程的化疗同步进行放疗.结果 术后随访5年,单纯化疗组和同步放化疗组分别有12例（22.2%）和6例（8.3%）局部复发,差异有统计学意义（P＜0.05）.两组远处转移率分别为51.9%（28/54）和47.4%（37/78）,差异无统计学意义（P＞0.05）.两组5年生存率分别为29.6%和47.4%,差异有统计学意义（P＜0.05）.除了6例（7.7%）放射性肠炎外,同步放化部组与单纯化疗组恶心呕吐和白细胞下降等不良反应的差异无统计学意义（P＞0.05）.结论 对于行Miles术Ⅲ期直肠癌患者,术后予以同步放化疗可降低局部复发率,提高5年生存率,是一项安全有效的辅助治疗方法.
Objective To evaluate the efficacy of postoperative chemoradiation for stage Ⅲ low rectal cancer. Methods A total of 132 patients with stage Ⅲ low rectal cancer, including 69 males and 63 females, were identified and divided into two groups： group A received chemoradiation while group B underwent chemotherapy alone. Results Eighteen patients developed local recurrence after five years of follow-up, with 6 cases（8.3%） in group A and 12（22.2%） in group B（P〈0.05）. In patients with distant metastasis（n=65）, 37（47.4%） were in group A and 28（51.9%） in group B, and the difference was not statistically significant（P〉0.05）. The 5-year survival rates for group A and group B were 47.4% and 29.6%, respectively（P〈0.05）. Radiation proctitis was found in 6 cases in group A. Conclusions Postoperative chemoradiation can reduce local recurrence rate and improve 5-year survival compared to chemotherapy alone. However, it has little effect on the distant metastasis Postoperative chemoradiation is safe and effective for low rectal cancer.
出处
《中华胃肠外科杂志》
CAS
北大核心
2010年第10期748-750,共3页
Chinese Journal of Gastrointestinal Surgery
关键词
直肠肿瘤
放射疗法
化学疗法
预后
Rectal neoplasms
Radiotherapy
Chemotherapy
Prognosis
