卡培他滨联合三维适形放疗治疗老年局部晚期直肠癌

目的:探讨卡培他滨联合三维适形放疗治疗老年局部晚期直肠癌的临床疗效及安全性。方法:58例经病理证实的老年局部晚期直肠癌患者,随机分为治疗组和对照组,治疗组33例接受三维适形放疗同步卡培他滨[1650 mg/(m2·d),分2次口服,第1¹4天,每3周为1个周期]化疗,共2个周期,对照组25例仅接受三维适形放疗。两组患者均接受全盆腔照射DT4614天,每3周为1个周期]化疗,共2个周期,对照组25例仅接受三维适形放疗。两组患者均接受全盆腔照射DT46⁵0 Gy,分2350 Gy,分23²5次,后缩野至肿瘤区继续推量DT1425次,后缩野至肿瘤区继续推量DT14¹8 Gy,分718 Gy,分7⁹次。治疗结束后3个月评价近期疗效,观察不良反应,随访生存情况。结果:治疗组近期有效率、2年局部复发率、远处转移率及生存率分别为75.76%,33.33%,30.30%,66.67%;对照组分别为52.00%,52.00%,56.00%,44.00%,两组比较近期有效率、远处转移率及生存率差异均有统计学意义(P<0.05),局部复发率及不良反应差异无统计学意义(P>0.05)。结论:70岁以上老年局部晚期直肠癌患者,可耐受同步放化疗,且疗效优于单纯放疗。

Capecitabine Combined with Three-dimensional Conformal Radiotherapy for Treating Elderly Patients with Local Advanced Rectal Cancer

Objective To explore the clinical efficacy and safety of capecitabine combined three-dimensional conformal radiotherapy in the treatment of elderly patients with local advanced rectal cancer. Methods Total 58 elderly patients with local advanced rectal cancer confirmed by pathology,were randomly divided into treatment group（ n = 33） and control group（ n =25）. The patients in treatment group received three-dimensional conformal radiotherapy and capecitabine administration with a dosage of 1 650 mg /（ m2·d） [oral with two doses]from the first to fourteen day,every 3 weeks for a cycle,wihle the patients in control group were only received radiotherapy. All patients received whole pelvic radiation with a dose of 46 to 50 Gy in 23 to 25 fractions,then reduced field to tumor region with a boost of 14 to 18 Gy in 7 to 9 fractions. The efficacy and adverse reactions were evaluated after 3 months,the survival state was followed up for 2 years. Results The recent efficiency,local recurrence rate in 2 years,distant metastasis rate and survival rate were 75. 76%,33. 33%,30. 30%,66. 67% in treatment group,were 52. 00%,52. 00%,56. 00%,44. 00% in control group,respectively. The local recurrence rate and side reaction did not show significant difference（ P〉0. 05）,but the recent efficiency,distant metastasis rate and survival rate were obviously difference between two groups（ P〈0. 05）. Conclusion Concurrent chemoradiotherapy can be tolerated by elderly patients with local advanced rectal cancer,moreover,the curative effect is better than single radiotherapy.