低位直肠癌术前放疗联合化疗的疗效观察

目的探讨术前化疗联合放疗在低位直肠癌治疗中的疗效。方法将70例低位直肠癌患者随机分为两组:单纯手术组进行常规手术治疗;综合治疗组予以卡培他滨口服和放疗后再手术。结果综合治疗组于放化疗结束后检查发现肿块均有不同程度缩小、活动度增加,下极距肛缘的距离延长0.8～1.5(平均1.2)cm;手术切除标本见大片坏死组织、细胞变性、癌周浸润消失以及肿块旁淋巴结大部分坏死和癌周血管闭塞。综合治疗组和单纯手术组的手术切除率分别为80.0%和100%,两组比较P<0.05;保肛率分别为34.3%和82.9%,两组比较P<0.01;局部复发率分别为17.9%和0,两组比较P<0.05;差异均有显著性意义。结论术前卡培他滨联合放疗对于低位直肠癌是目前较好的新辅助治疗方案。

Combined preoperative chemotherapy with radiotherapy for lower rectal cancer

Objective To explore the effect of combined preoperative chemotherapy with radiotherapy for lower rectal carcinoma. Methods Seventy patients with lower rectal cancer were randomly divided into two groups. Thirty five patients in group A were treated with operation alone and other 35 patients in group B received combined chemotherapy of capecitabine with radiotherapy before operation. Results After neoadjuvant therapy,the tumors became smaller and more movable,and the distance from the lower edge of the tumor to the anal level was extended 0.8 to 1.5 cm. Postoperative pathological examination of surgical specimens revealed tumor tissue necrosis,paratumor infiltration disappearance,paratumor lymph node necrosis and blood vessel occlusion. The resection rates were 80.0%and 100%(P< 0.05),anal preservation rates were 34.3%and 82.9%(P< 0.01), and local recurrence rates were 17.9%and 0(P< 0.05) respectively in group A and group B. Conclusion Combined preoperative chemotherapy with radiotherapy is a better neoadjuvant therapy for lower rectal carcinoma.