三维适形放疗联合卡培他滨治疗局部晚期（不可手术）直肠癌

目的观察三维适形放疗同期口服卡培他滨治疗局部晚期（不可手术）直肠癌患者的近期疗效及治疗的依从性。方法38例经病理证实的局部晚期（T4或局部-区域复发）的直肠癌患者接受了全盆腔三维适形放疗（3DCRT）,DT46～50Gy/23～25F,后缩野至肿瘤区继续推量至DT64～66Gy/32～33F,同期接受卡培他滨（1650mg.m-2.d-1）治疗,分2次口服,第1～14天,每3周为1个周期,共服用2个周期。结果疗效评价：CR5例（13.2%）,PR17例（44.7%）,SD10例（26.3%）,PD6例（15.8%）,总有效率（CR＋PR）57.9%;中位生存时间18.0个月,1年和2年总生存率分别为63.43%和18.78%。疼痛症状缓解率为100%;全身状况好转率52.8%。治疗相关的毒副反应以腹泻、中性粒细胞减少及手足综合征为主,其Ⅲ级反应的发生率分别为15.8%、15.8%和7.9%,均无Ⅲ级以上反应。结论3DCRT联合口服单药卡培他滨的同期放化疗方案是局部晚期（不可手术）直肠癌较好的治疗方法,其治疗的依从性高、毒副反应轻、近期疗效肯定、姑息性减症作用明显,值得临床推广应用。

Three Dimensional-conformal Radiotherapy Combined with Capecitabine Chemotherapy for Locally Advanced (Unresectable) Rectal Cancer

Objective To evaluate the compliance and efficacy of chemoradiotherapy for locally advanced（unresectable）rectal cancer.Methods Thirty eight patients with locally advanced（T4 or recurred）rectal cancer received three dimensional-conformal radiotherapy（for 46~50Gy/5 weeks and was boosted to the tumor 16~18Gy/2 weeks,2Gy/fraction,5 days/week）in combination with capecitabine 1 650mg·m-2·d-1,day 1-14,every 3 weeks.Results The overall response rate was 57.9%,with CR 5（13.2%）,PR 17（44.7%）,SD 10（26.3%）,PD 6（15.8%）,median survival time,the 1-year overall survival rate and the 2-year overall survival rate were 18 months,64.43%,18.78%,respectively.The remission rate of pain and improvement rate of performance status were 100% and 52.8%.Treatment-related toxicity mainly showed at diarrhea、neutrocytopenia and hand-foot syndrome,the incidence of grade 3 toxicity were 15.8%,15.8%,7.9%,respectively.there were no grade 4 toxicity and treatment-related death.Conclusion Combination of three dimensional-conformal radiotherapy with capecitabine is active in advanced rectal cancer,It is a well-tolerated regimen.