直肠癌手术前后放化疗疗效的研究

目的比较术前和术后放化疗对直肠癌病人疗效的影响。方法选取确诊的158例中晚期直肠癌患者，随机分为两组，78例接受直肠癌手术前放化疗联合治疗（术前放化疗组），80例接受直肠癌手术后放化疗联合治疗（术后放化疗组），随访6年，比较两组患者手术保肛率、生存率、放化疗急性反应发生率与严重程度、局部复发率、远处转移率等指标。结果术前放化疗组的保肛率（93．15％）大于术后放化疗组的保肛率（68．42％），局部复发率（16．44％）高于术后放化疗组的局部复发率（3．95％），差异均有统计学意义（X2分别=14．53、6．42，P均〈O．05）；两组患者肿瘤远处转移率、生存率比较，差异均无统计学意义（X2分别=0．74、0．05，P均〉0．05）；两组均没有出现4级以上毒副反应情况，两组的患者皮肤放射反应、胃肠道反应、膀胱放射反应和骨髓抑制反应比较，差异亦均无统计学意义（U分别=0．15、0．72、0．56、0．82，PN〉0．05）。结论术前放化疗和术后放化疗患者的毒副作用基本相似，但是术前放化疗患者的手术保肛率要高，术后放化疗患者的局部复发率要低于术前。

Effect of preoperation and postoperation chemoradiotherapy on rectal cancer

Objective To compare the effect of preoperation and postoperation chemoradiotherapy on rectal cancer. Methods A total of 158 cases of defined rectal cancers were randomly divided into two groups. Among them, 78 cases accepted preoperation radiotherapy and chemotherapy while other 80 cases accepted postoperation radiotherapy and chemotherapy. Followed up all the patients for 6 years, the surgica｜ sphincter preservation, survival rate, chemoradiother- apy acute reaction incidence and severity of local recurrence rate, distant metastasis rate and other indicators were com- pared. Results The sphincter preservation rate of preoperative group （93.15%） was higher than that of the postoperative group （68.42%）. The local recurrence rate of preoperative group （16.44%） was higher than that of the postoperative group （3.95%）. The differences were significant （X2=14.53,6.42,P〈0.05）. There was no significant difference of tumor metasta- sis rate, survival rate between the two groups （X2=0.74,0.05, P〉0.05 ）. There were no significant difference of skin radia- tion reaction, gastrointestinal tract, bladder radiation reaction and marrow suppression between two groups （U=O.15, 0.72,0.56,0.82,P〉0.05）. Conclusions Basic side effects of preoperation and postoperation chemoradiotherapy was simi- lar. But surgical sphincter preservation and local recurrence rate of preoperative chemoradiotherapy was higher than those of the postoperative chemoradiotherapy.