摘要
目的评价新辅助放化疗联合直肠癌根治术治疗中晚期直肠癌的临床疗效。方法将51例中晚期直肠癌患者按随机数字表法分为治疗组和对照组，治疗组26例，术前给予三维适形放疗同步XELOX方案化疗2个周期，治疗结束后4—6周行直肠癌根治术。对照组25例，给予XELOX方案化疗2个周期后行直肠癌根治术。结果治疗组客观有效率为84．6％（22／26），对照组为60．0％（15／25），两组比较差异有统计学意义（P=0．049）。治疗组根治性切除率为96．2％（25／26），明显高于对照组的76．0％（19／25），差异有统计学意义（P=0．037）。治疗组保肛率为61．5％（16／26），对照组为20．0％（5／25），两组比较差异有统计学意义（P：0．003）。治疗组病理完全缓解率为26．9％（7／26），明显高于对照组的4．0％（1／25），差异有统计学意义（P=0．024）。治疗组1、2、3年生存率分别为88．0％（22／25）、60.0％（15／25）、32．0％（8／25），显著高于对照组的62．5％（15／24）、29．2％（7／24）、8．3％（2／24），差异有统计学意义（P=0．038、0．030、0．040）。治疗组1、2、3年复发率分别为8．0％（2／25）、20．0％（5／25）、36．0％（9／25），显著低于对照组的33．3％（8／24）、50．0％（12／24）、66．7％（16／24），差异有统计学意义（P=0．028、0．027、0．032）。结论新辅助放化疗联合直肠癌根治术可以提高手术切除率、保肛率，延长生存期，可作为治疗中晚期直肠癌的一种有效治疗方法。
Objective To evaluate the clinical efficacy ot neoadjuvant chemo radiomerapy combined with surgical treatment for advanced rectal cancer. Methods Fifty-one patients with advanced rectal cancer were randomly divided into treatment group and control group by random number table.In treatment group, 26 cases received three-dimensional conformal radiotherapy synchronization XELOX chemotherapy for 2 cycles, then they received radical resection after 4 - 6 weeks. Twenty-five cases in control group received neoadjuvant chemotherapy with XELOX for 2 cycles, then received radical resection. Results The objective response rate in treatment group was 84.6% （22/26）, and in control group was 60.0% （15/25） ,there was significant difference between two groups （P = 0.049）. Radical resection in treatment group was 96.2% （25/26）, significantly higher than that in control group 76.0% （19/25）（P = 0.037）. The sphincter preservation rate in treatment group was 61.5% （ 16/26 ）, and in control group was 20.0% （5/25）, there was significant difference between two groups （P = 0.003）. The pathologic complete response rate in treatment group was 26.9% （7/26）, significantly higher than that in control group 4.0% （1/25）（P = 0.024）. The 1, 2 and 3 year survival rate in treatment group were 88.0% （22/25）, 60.0% （15/25）, 32.0% （8/25）, which were significantly higher than those in control group 62.5 % （ 15/24 ）, 29.2% （ 7/24 ）, 8.3 % （ 2/24 ） （ P = 0.038,0.030,0.040）. The 1, 2,and 3 year recurrence rate in treatment group were 8.0%（2/25）, 20.0% （5/25）, 36.0% （9/25）,which were significantly lower than those in control group 33.3%（8/24）, 44.8% （12/24）, 66.7% （16/24） （P=0.028,0.027,0.032）. Conclusion Neoadjuvant chemoradiotherapy can improve the rate of surgical resection, sphincter preservation and prolong survival of rectal cancer, it can be used as a kind of effective treatment for rectal cancer.
出处
《中国医师进修杂志》
2013年第17期10-14,共5页
Chinese Journal of Postgraduates of Medicine
关键词
直肠肿瘤
放射疗法
新辅助化疗
Rectal neoplasms
Radiotherapy
Neoadjuvant chemotherapy
