术前三维适形放疗并卡培他滨治疗局部晚期直肠癌的临床研究

目的：评价术前三维适形放疗并卡培他滨治疗局部晚期直肠癌的耐受性和有效性。方法：45例初诊局部晚期直肠癌患者入组，治疗前经病理确诊：直肠腺癌。所有患者予三维适形放疗：DT50 Gy/25次。化疗在放疗的第l天开始给药，卡培他滨825 mg/m2．次，2次/d，与放疗同步（每周5天）。手术在放化疗结束5、6周后进行。结果：完成术前计划并进行手术者43例。手术标本总有效率56．3％，肿瘤全消6例，仅见少量肿瘤残留16例。全组无4级毒副反应发生，3级毒副反应包括：放射性皮炎l例，腹泻2例，放射性肠炎1例。结论：术前三维适形放疗并卡培他滨治疗局部晚期直肠癌明显降低肿瘤分期、提高手术保肛率，且不良反应少，大多数患者可耐受。

Clinical research of preopre ative three-dimensional conform al radiotherapy in combi nat ion with ac peic tabine in treatm ent of locally advanced rectal cancer

Objective：To evaluate the efficiency and tolerance of pre -operative three dimensional -conformal radiotherapy combined with Capecitabine chemotherapy for locally advanced rectal cancer .Methods：45 cases of newly diagnosed locally advanced rectal cancers were collected which were rectal adenocarcinoma confirmed by pathological diagnosis .Three dimensional -conformal radiation therapy was given at a dose of 2.0 Gy per day, 5 days per week, for 5 weeks with a total radiation dose of 50Gy.825 mg of capecitabine per square meter of body-surface area per day were given twice each day and five days per week .Surgical removal of tumor was performed within 5-6 weeks after completion of chemoradiotherapy .Results：43 cases completed chemoradiotherapy and underwent surgery and 2 cases were exclude for serious adverse events.The overall response（CR plus PR） rates were 56.3%.6 cases achieved clinical complete response （ CR） and 16 cases achieved partial response （ PR） .No case with Grade 4 toxic effects was observation .4 cases with Grade 3 toxic effects was observation：1 case of radioactive dermatitis ,2 cases of diarrhea ,1 case of radioactive enteritis .Conclusion：Three dimensional -con-formal radiotherapy combined with capecitabine chemotherapy were effective for resulting in down -staging of tumour , increasing the rate of anal-saving operation , reducing adverse reactions .