三维适形放疗同步化疗直肠癌术后局部复发或盆腔转移的疗效观察

目的 评价三维适形放疗(3DCRT)同步奥沙利铂+希罗达化疗直肠癌术后局部复发或盆腔转移的局部控制率、生存期和毒副作用.方法 回顾性分析近2年收治的直肠癌术后局部复发或盆腔转移患者47例,应用3DCRT 1.8～2.0 Gy/次,DT55～65 cy,同步行奥沙利铂+希罗达化疗,奥沙利铂100 mg/m2,静脉滴注第1天,希罗达1500 mg/m2,分2次口服第1～14天,21 d为1个周期.放疗期间化疗2周期,结束后化疗2～4周期.结果 完全缓解率19%(9例),部分缓解率60%(28例),有效率79%,疼痛缓解率85%(40例),缓解时间平均为6个月.l、2年生存率分别为83%、51%,牛活质量明显改善,无治疗相关性死亡.结论 3DCRT同步奥沙利铂+希罗达化疗直肠癌术后盆腔局部复发或转移可提高局部控制率和延长生存期,提高生活质量,毒副反应可耐受.

Result of 3-dimensional conformal radiotherapy combined with concurrent chemotherapy for postoperatively Ioco-regionally recurrent or mastastatic rectal cancer

Objective To evaluate the efficacy of three-dimensional conformal radiotherapy (3DCRT) combined with concurrent chemotherapy for loco-regionally recurrent or mastastatie rectal cancer. Methods Between June 2004 and January 2007,47 patients with loco-regionally recurrent or nmatastatic rectal cancer were treated by 3DCRT of 55-65 Gy in 1.8-2.0 Gy fractions. Chemotherapy was given concurrenfly using oxaliplatin(100 mg/m2 ,iv drop,d1 ) and capecitabine(1500 mg/m2,orally,dl-14,21 days per cycle). Results After the follow-up of 12-35 months, the total response rate, complete response rate and partial response rate were 79% (37/47) ,19% (9/47) and 60% (28/47) ,respectively. The pain-alleviation rate and the mean pain-alleviation time were 85% and 6 months. The 1- and 2-year survival rates were 83% and 51%. Quality of life was improved without any treatment related death. Conclusions 3DCRT combined with concurrent chemotherapy is effective and well-tolerated in patients with post-operatively locoregionally recurrent or mastastatic rectal cancer.