新辅助放化疗联合热疗治疗进展期直肠癌的临床效果和安全性

目的探讨新辅助放化疗联合热疗治疗进展期直肠癌临床效果和安全性。方法选取2010年8月。2012年9月金华市中心医院治疗的进展期直肠癌患者68例，按治疗方法不同分为对照组及实验组，每组各34例。对照组患者采用新辅助放化疗治疗（卡培他滨化疗＋直线加速器照射放疗），实验组则进行新辅助放化疗联合热疗治疗（卡培他滨化疗＋直线加速器照射放疗＋热疗）。观察并比较两组患者治疗后的临床效果及副作用．以及跟踪随访半年后患者的复发及转移情况。结果治疗后实验组总有效率（82，35％）明显高于对照组（47．06％），差异有统计学意义（P〈0．05）。实验组患者恶心呕吐（2．94％）、腹泻（5．88％）、皮肤反应（0．00％）、白细胞减少（2．94％）、血小板减少（2．94％）发生率明显低于对照组（20．59％、14．71％、8．82％、23．53％、11．76％），差异有统计学意义（P〈0．05）。实验组患者治疗半年后复发率（2．94％）及转移率（5．88％）明显低于对照组（14．71％、35．29％）．差异有统计学意义（P〈0．05）。结论新辅助放化疗联合热疗治疗进展期直肠癌效果明显，可以有效缩小肿瘤的体积，降低癌症临床分期，可以杀灭病灶，有效避免肿瘤向远处转移，从而减少局部复发，此治疗法对患者副作用较少，安全可靠，可在临床上推广应用。

Clinical effect and safety of advanced rectal cancer treated with hyper-thermia combined neoadjuvant chemotherapy

Objective To explore the clinical effect and safety of advanced rectal cancer treated with hyperthermia combined neoadjuvant chemotherapy. Methods 68 patients of advanced rectal cancer from August 2010 to September 2012 in Central Hospital of Jinhua City were chosen and divided into control group and experiment group and with 34 patients in each group. The control group was treated with neoadjuvant ehcmoradiotherapy （Capeeitabine chemotherapy＋linear accelerator radiothera- py）, while the experiment group was treated with hyperthermia therapy combined with neoadjuvant chemotherapy （Capecitabine chemotherapy＋linear accelerator radiotherapy＋hyperthermia therapy）. The clinical effects of the two groups were compared and observed. The side effects after the treatment and the conditions of recurrence and metastasis in the following half year were observed. Results After the treatment of the two groups, the total efficiency of the experiment group （82.35%） was obviously higher than that of the control group （47.06%）, the differences were statistically significant （P 〈 0.05）. The ap- pearance rate of nausea and vomiting （2.94%）, diarrhea （5.88%）, skin reaction （0.00%）, leucopenia （2.94%）, thrombocytopenia （2.94%） were both obviously lower than those of the control group （20.59%, 14.71%, 8.82%, 23.53%, 11.76%）, the differences were statistically significant （P 〈 0.05）. And the recurrence rate and metastasis rate of experiment group （2.94%, 5.88%） were both obviously lower than those of the control group （14.71%, 35.29%）, the differences were statistically significant （P 〈 0.05）. Conclusion The hyperthermia combined with neoadjuvant chemotherapy has an obvious effect on advanced rectal cancer, which can effectively reduce the size of a tumor and the cancer clinical stage, and avoid the tumor to distant metastasis, so as to kill the local recurrence. The treatment has few side effects on the patients with great safety, it is worthy of clinical use.