晚期复发转移直肠癌56例同步放化疗的疗效观察

目的观察FOLFOX4联合放疗治疗晚期复发转移直肠癌的疗效与毒性反应。方法对56例无法手术的晚期或复发直肠癌患者进行盆腔放疗，在放疗的第1、5周同时给予FOLFOX4方案化疗，以56例单纯同方案化疗者为对照组。结果单纯化疗组、放化疗组的有效率分别为66．1％、83．9％（P〈0．05）；肛门、会阴疼痛缓解率分别为30．4％、55．4％；粘液血便缓解率分别为17．9％、30．4％；无病生存期分别为10．8个月、12．6个月（P〉0．05）；中位生存期分别为17．2个月、21．8个月（P〈0．05）。主要毒副反应是消化道反应、神经毒性、骨髓抑制，经对症和支持治疗后患者均能够耐受。结论FOLFOX4方案化疗与盆腔同步放疗治疗晚期及复发转移直肠癌能较好控制局部复发病灶，控制远处转移，改善局部症状，提高生活质量及生存期。

Observation on effect of synchronization chemotherapy combined with radiotherapy in fifty-six patients with advanced recurrent rectal cancer

Objective To evaluate the efficacy and toxicity reaction of FOLFOX4 chemotherapy with radiotherapy in the treatment of advanced recurrent rectal cancer. Methods Fifty-six patients with advanced recurrent rectal cancer received radiotherapy administered to the pelvic, and the FOLFOX4 chemotherapy were given during week 1 and 5 of standard radiotherapy（ treatment group）. Fifty-six patients with advanced recurrent rectal cancer received the same chemotherapy alone were as control group. Results The overall response rate was 66. 1% in control group and 83.9% in treatment group （P 〈0. 05）. The pain of anus and perineum rate were 30. 4% and 55.4% respectively; the mucous secretion and blood stool relief rate were 17.9% and 30. 4%. The median time to progression （TIP） was 10. 8 months and 12. 6 months（ P 〉 0.05 ）. The middle survival time （MST） was 17.2 months and 21.8 months（P 〈 0. 05）. The main acute toxicities, including digestive tract reaction, neuritis sensory toxicity, bone marrow suppression, were tolerated in patients. Conclusion The FOLFOX4 chemotherapy combined with pelvic radiotherapy is more effecttive than chemotherapy alone and is tolerated in patients with advanced recurrent rectal cancer.