摘要
目的探讨新辅助同步放射治疗和化学治疗联合全直肠系膜切除术（TME）治疗中低位局部进展期直肠癌的疗效。方法选择40例中低位局部进展期直肠癌患者,接受术前同步放射治疗和化学治疗。同步放射治疗和化学治疗结束后4-6周行手术治疗。结果所有患者均完成同步放射治疗和化学治疗,其中完全缓解7例,部分缓解23例,稳定10例;30例（75.0%）患者肿瘤的临床分期下降。8例行腹会阴联合切除术（Miles术）,32例行低位或超低位前切除术（Dixon术）,保肛率为80.0%。无围术期死亡病例,术后并发症的总发生率为17.5%。手术标本显示肿瘤已完全消失7例,肿瘤降期明显。结论新辅助同步放射治疗和化学治疗联合TME治疗中低位局部进展期直肠癌能使肿瘤分期降低,提高保肛率,改善患者的生活质量。
Objective To evaluate the efficacy of neoadjuvant concurrent chemoradiotherapy combined with total mesorectal excision（ TME） for the treatment on locally advanced middle and lower rectal cancer. Methods Forty patients with locally advanced middle and lower rectal cancer were recruited. All patients received neoadjuvant concurrent chemoradiotherapy.The surgical operation was performed 4- 6 weeks after concurrent chemoradiotherapy. Results All patients completed the neoadjuvant concurrent chemoradiotherapy. Among forty patients,7 received complete response,23 received partial response,10received stable disease. And 30 patients（ 75. 0%） obtained downstaging. Eight patients received abdominoperineal resection（ Miles）,and 32 patients received low/ultra-low anterior resection（ Dixon）. The sphincter preservation rate was 80. 0%. No perioperative death was found,and the overall incidence of complication was 17. 5%,as a result of examination of the surgical specimens,7 patients had a complete pathologic response,downstaging was obtained. Conclusion Neoadjuvant concurrent chemoradiotherapy combined with TME for treatment of locally advanced middle and lower rectal cancer is effective and safe,which can reduce the tumor stage and increased the complete tumor resection and sphincter preservation rates,and can also improve the quality of life.
出处
《新乡医学院学报》
CAS
2014年第8期665-667,共3页
Journal of Xinxiang Medical University
