手术联合术前后放化疗治疗直肠癌的疗效研究

目的 探讨手术联合术前后放化疗治疗直肠癌的临床疗效.方法 将186例行手术治疗的直肠患者分为观察组和对照组,对照组患者术后给予放化疗,而观察组在术前后均进行放化疗,观察两组肿瘤降期情况、临床症状改善情况、生活质量、放化疗耐受性、血清肿瘤标志物水平及保肛率,随访3年,比较两组局部复发率及总生存率.结果 观察组患者术前肿瘤降期比例及临床症状积分均高于对照组,组间差异有统计学意义(P<0.05).观察组生活质量改善情况、保肛率及血清肿瘤标志物水平均优于对照组,组间差异有统计学意义(P<0.05).随访3年,观察组中位生存时间、3年局部复发率及总生存率均优于对照组,组间差异有统计学意义(P<0.05).结论 手术联合术前后放化疗能有效降低术前肿瘤分期,提高患者手术治疗效果及生活质量,减少术后局部复发,提高远期生存率.

Clinical Study of Surgical Resection Combined with Preoperative Radio-chemotherapy for Rectal Cancer

Objective To explore the clinical efficacy of surgical resection combined with preoperative radio -chemother-apy for rectal cancer.Methods 186 patients with rectal cancer were divided into the control group and the observation group ,in-cluding 97 patients who received preoperative and postoperative radio-chemotherapy plus surgery ( the observation group ) and 89 patients who received postoperative radio-chemotherapy plus surgery ( the control group ) ,stage of tumor ,clinical symptoms ,the in-cidence of radio-chemotherapy tolerance , the rate of sphincter preservation , quality of life and level of tumor marker were ob-served.Follow up for 3 years,the rate of local recurrence and the rate of overall survival in the 2 groups were compared.Results The observation group was significantly higher than the control group in the reduction ratio of tumor stage and clinical symptom score(P<0.05).The observation group was significantly better than the control group in KPS score ,the rate of sphincter preser-vation and the level of tumor marker (P<0.05).Follow up for 3 years,the observation group was significantly better than the con-trol group in the rate of local recurrence ,3-year survival rate and the median survival time (P<0.05).Conclusion Preoperative radio-chemotherapy can significantly reduce the stage of tumor ,improve the effect of surgical treatment and quality of life ,reduce postoperative local recurrence and improve long-term survival rate.