放疗加化疗治疗直肠癌术后复发58例临床观察

目的探讨后程适形放疗加化疗治疗术后复发直肠癌的疗效.方法 58例术后复发直肠癌随机分为后程适形放疗加化疗组（适形组）29例,普放加化疗组（对照组）29例.前程采用三野等中心照射40GY,后予适形推量至65～70GY,对照组后程用两斜野照射推量至DT55～60GY,两组均于放疗第一周予FP方案（5-Fu 500mg/m2 d1～5;DDP 30mg/m2 d1～3）化疗一周期,放疗结束后再化疗3～5周期.结果适形组和对照组3年局部控制率分别为65.5%、48.3%（P〈0.05）,适形组和对照组1、3年生存率分别为89.3%、58.6%和82.8%、41.3%（P〈0.05）,中位生存时间分别为30和21个月.毒副反应两组无统计学差异,患者均可耐受.结论后程适形放疗加化疗治疗术后复发直肠癌有较好疗效,毒副反应可耐受,值得推广使用.

Study of late course three dimensional-conformal radiotherapy combined with chemotherapy for 29 cases with recurrent rectal cancer

Objective To study the effect of recurrent rectal cancer teated by three dimensional-conformal radiotherapy(3D-CRT) combined with chemotherapy(CT).Methods Total of 58 patients with recurrent rectal cancer were divided randomly into two groups:29 cases received CT plus 3D-CRT(3D-CRT group);29 cases received CT plus conventional radiotherapy(control group).A total tumor dose of 40 Gy by three-field from the same center for conventional radiotherapy in the first course;followed in the 3D-CRT group by 3D-CRT to DT65~70Gy,in the control group by two-field for conventional radiotherapy to DT55~60Gy.Two goups were all treated one course by FP precept in the first week,and then 3~5courses were given after the end of radiotherapy.Results The 3-year local regional control rates for 3D-CRT group and control group were 65.5%,48.3%(P<0.05);the 1-and 2-year survival rates for two groups were 89.3%,58.6% and 82.8%,41.3%(P<0.05),middle survival time were 30 and 21 months.The side effects were similar in the two groups.Conclusion 3D-CRT plus CT may significantly improve the effect of the treatmentin in recurrent rectal cancer patients.