新辅助化放疗在局部进展期低位直肠癌保留肛门括约肌的作用

Role of sphincter preserving surgery with neoadjuant chemoradiotherapy for locally advanced Iow rectal cancer

AIM: To evaluate the role of the sphincter preserving surgery with neoadjuvant chemoradiotherapy in locally advanced low rectal cancer. METHODS: Forty-two patients with T3 and T4 low rectal cancer were treated by pre-operative radiotherapy to pelvis, 2 Gy daily up to 40-46 Gy in 4 weeks concomitantly with oral administration of capecitabine (CAP) at 1250 mg/m2 bid for 10 weeks (group A). Twenty-one patients were treated by the same chemoradiotherapy after operation (group B). RESULTS: Neoadjuvant chemoradiotherapy (NCR) was successfully completed in group A. Among the 42 patients, tumor lesions disappeared in 5 cases, so they didn't receive operation. Curative resection was carried out in the remaining 37 patients, of which 33 received the sphincter-saving resection (SSR) and 4 received abdomino-perineal resection (APR). The rate of sphincter preservation was 89.2% in group A. Of the 21 patients in group B, 11 received SSR and 10 received APR. The rate of sphincter preservation was 52.4% in group B. CONCLUSION: NCR shows high efficacy in tumor down-staging and shrinkage of tumor mass, and improves the resection rate and sphincter preservation.