同步新辅助放化疗应用于中低位进展期直肠癌患者全直肠系膜切除术前的效果分析

目的分析同步新辅助放化疗应用于中低位进展期直肠癌患者全直肠系膜切除术前的效果。方法80例中低位进展期直肠癌患者,根据治疗方法不同分为对照组和试验组,每组40例。对照组患者使用全直肠系膜切除术治疗,试验组患者在对照组基础上于术前实施同步新辅助放化疗。比较两组患者治疗前后肿瘤标志物水平及保肛、复发、转移、并发症发生情况。结果治疗前,两组患者癌胚抗原、糖链抗原19-9、糖链抗原242水平比较差异无统计学意义(P>0.05);治疗后,两组患者癌胚抗原、糖链抗原19-9、糖链抗原242水平均优于本组治疗前,且试验组优于对照组,差异具有统计学意义(P<0.05)。试验组患者保肛率92.50%高于对照组的60.00%,复发率5.00%、转移率0低于对照组的30.00%、10.00%,差异具有统计学意义(χ^2=11.6652、8.6580、4.2105,P=0.0006、0.0032、0.0401<0.05)。试验组患者并发症发生率为10.00%,低于对照组的27.50%,差异具有统计学意义(χ^2=4.0205,P=0.0449<0.05)。结论同步新辅助放化疗应用于中低位进展期直肠癌患者全直肠系膜切除术前的效果较好,能有效降低患者肿瘤标志物水平,提升患者保肛率,降低患者的复发率、转移率和并发症发生率,具有较高临床价值。

Analysis of the effect of simultaneous neoadjuvant chemoradiotherapy on total mesorectal excision in patients with low-to-advanced advanced rectal cancer

Objective To analyze the effect of simultaneous neoadjuvant chemoradiotherapy on total mesorectal excision in patients with low-to-advanced advanced rectal cancer.Methods A total of 80 patients with low-to-advanced advanced rectal cancer were divided into control group and experimental group by different treatment methods,with 40 cases in each group.The control group was treated by total mesorectal excision,and the experimental group received simultaneous neoadjuvant chemoradiotherapy before operation on the basis of the control group.The level of tumor markers before and after treatment and anus preservation,recurrence,metastasis and the occurrence of complications were compared between the two groups.Results Before treatment,there was no statistically significant difference in carcinoembryonic antigen,carbohydrate antigen 19-9 and carbohydrate antigen 242 levels between the two groups(P>0.05).After treatment,the experimental group was better than the control group,and the difference was statistically significant(P<0.05).The anus preservation rate 92.50%in the experimental group was higher than 60.00%in the control group,and recurrence rate and metastasis rate were 5.00%and 0 respectively,which was lower than 30.00%and 10.00%in the control group.Their difference was statistically significant(χ^2=11.6652,8.6580,4.2105;P=0.0006,0.0032,0.0401<0.05).The incidence of complications was 10.00%in the experimental group,which was lower than 27.50%in the control group,and the difference was statistically significant(χ^2=4.0205,P=0.0449<0.05).Conclusion Simultaneous neoadjuvant chemoradiotherapy shows good effect on total mesorectal excision in patients with low-to-advanced advanced rectal cancer.It can effectively reduce the level of tumor markers,improve anus preservation rate,reduce the recurrence rate,metastasis rate and complication rate of patients.This method contains a high clinical value.