术前放化疗治疗ⅡⅢ期直肠癌的临床研究

目的探讨术前放疗配合化疗治疗中晚期直肠癌的临床价值。方法73例Ⅱ-Ⅲ期直肠癌患者被随机分为两组。试验组为术前放疗配合化疗组;对照组为术前化疗组。结果两组均可使直肠癌发生坏死,降低肿瘤分期,甚至达到病理性CR,但是治疗组比对照组更能提高肿瘤降级率、病理CR率、保肛率,同时降低复发率（P〈0.05）。然而该治疗并不能改善患者5年总的生存率和无病生存率,也不增加3P4毒性反应（P〉0.05）。结论术前放疗配合化疗可以降低肿瘤分期,缩小肿瘤浸润范围,减少直肠癌病人术后的局部复发及提高低位直肠癌手术的保肛率,是一种安全有效的治疗。

Clinical study of three dimensional-conformal radiotherapy concurrent chemotherapy for medium-advanced rectalcancer

Background and purpose To study the value of three dimensional-conformal radiotherapy concurrent chemotherapy for advanced rectal cancer.Methods 73 Ⅱ-Ⅲ patients with stage Ⅱ-Ⅲ rectal cancer were randomly divided into experimental group who were performed with three dimensional-conformal radiotherapy concurrent chemotherapy and contral group who were performed with routine radiotherapy concurrent chemotherapy before operation.Results The two means can necrotize tumor and tumor stages were down staged,even to CR.However,3DCRT precedes routine radiotherapy to improve the rate of debased stage,of sphincter preservation and CR and to reduce the rate of relapse and toxicity of 3P4（P〈0.05）.However,3DCRT cannot improve the 5 years total survival rate and free-disease survival rate more than routine radiotherapy,and their 3p4 were not remarkable difference.（P〉0.05）.Conclusions 3DCRT has shown its efficacy in reducing stage and improving the sphincter preservation and can decrease the local recurrence rates.It is a safe effective therapy.