局部晚期低位直肠癌术前不同放疗模式疗效观察

目的：探讨术前不同放疗模式对局部晚期低位直肠癌的治疗意义。方法：40例局部晚期低位直肠癌患者,其中23例采用术前同步放化疗,放疗方式采用盆腔外照射,DT 50戈瑞/25次,化疗方案为卡培他滨750毫克/米2,每日两次口服,间隔12小时,连用5周,照射结束后4周手术。另17例患者采用短程低分割放疗方案,DT 25戈瑞/5次/5天,照射结束后1周左右手术。结果：术前同步放化疗组和术前短程低分割组有效率分别为78.2%和58.8%,保肛率分别为73.9%和44.4%,病理完全消失率分别为13.0%和0,3年生存率分别为73.9%和58.8%,P〈0.05,均有统计学差异。术后吻合口瘘发生率分别为4.3%和4.1%,P〉0.05无统计学差异。结论：局部晚期低位直肠癌术前同步放化疗临床疗效好,生存质量高,为优先选择方案。

Effect of different preoperative radiotherapy models for locally advanced low rectal cancer

Objective：To observe the effect of different preoperative radiotherapy for locally advanced rectal cancer. Methods： Of 40 cases,23 were treated with concurrent radiochemotherapy,using pelvic irradiation,DT 50Gy/25times, chemotherapy ： capecitabine 750mg/m2,twice a day orally,interval of 12 hours,last 5 weeks,after 4 weeks operation was performed .Other 17 patients were treated with radiotherapy of short-range low segmentation schemes,DT 25Gy/5times/5 days,after 1 week operation was performed. Results： Preoperative concurrent radiochemotherapy group and separate groups of preoperative short-range efficiency rates were 78.2% and 58.8%,sphincter preservation rates were 73.9% and 44.4%,pathological disappearance rates were 13.0% and 0,3-year survival rates were 73.9% and 58.8%,P0.05. The incidence of postoperative anastomotic leakage was 4.3% and 4.1%,P0.05. Congclusion： The clinical effect of preoperative concurrent radiochemotherapy for locally advanced low rectal cancer was good with high quality of life and a priority option.