DukesC期直肠癌Miles术后同步放化疗与单纯化疗的疗效对比分析

为对比分析DukesC期直肠癌患者行腹会阴联合切除术（Miles术）后同步放化疗与单纯化疗的疗效，本研究统计符合条件的临床病例132例，其中54例术后予以单纯化疗，78例术后予以同步放化疗。化疗方案：奥沙利铂130mg／m^2，d1；亚叶酸钙100mg／m^2，d1-5；氟尿嘧啶350mg／m^2，d1-5；每月化疗1次，连续化疗6个月。放射治疗方法：术后放射治疗定位采用CT模拟机，应用15MVX线，1．8Gy／次，4次／周，共7周，总剂量为50．4Gy。随访5年，观察患者局部复发、远处转移和5年生存情况。结果显示，（1）局部复发：单纯化疗组12例（22．22％），同步放化疗组6例（7．69％），两组局部复发率差异有统计学意义，P〈0．05。（2）远处转移：单纯化疗组28例（51．85％），同步放化疗组37例（47．44％），两组远处转移率差异无统计学意义，P〉0．05。（3）5年生存情况：单纯化疗组16例（29．63％），同步放化疗组37例（47．44％），两组5年生存率差异有统计学意义，P〈0．05。结果表明，DukesC期直肠癌患者Miles术后行同步放化疗，与单纯化疗相比，局部复发率降低，5年生存率升高，远处转移率相近。

Comparison on the Therapeutic Efficacies of the Synchronous Radiotherapy and Chemotherapy and alone Chemotherapy after Milers Operation for Dukes C Stage Rectal Carcinoma

The objective of the study was to compare the therapeutic efficacy of the postoperative synchronous radiotherapy and chemotherapy and alone chemotherapy. One hundred and thirty two patients with rectal carcinoma of Dukes C stage who had undergone Mile＇s operation were included in the study,of whom 54 received alone chemotherapy（AC group）,while 78 underwent synchronous radiotherapy and chemotherapy（SRC group）. The chemotherapy scheme included： L-OHP 130mg/m^2 , d1 ;calcium folinate 100mg/m^2 , d1-5 ;fluorouracil 350 mg/m^2 ,d1-5 ;once every month,for 6 months. The radiotherapy; the location take CT- analog machine in postoperation radio treatment, 15 MV X-ray was used, 1.8 Gy each time,4 times each week, 7 weeks in all, total dose was 50.4Gy. 5 years＇ follow up showed that local recurrence was noticed in 12 cases in AC group（22.22%） against 6 cases in SRC group（7.69%）（ P〈0.05） ,that distant metastasis was detected in 28 cases （51.85%） in AC group against 37 cases（47.44%） in SRC group （ P 〉0.05）,and that 5-year survival was noticed in 16 cases（29. 63%） in AC group against 37 cases （47. 44%） in SRC group （P 〈0. 05）. It is concluded that postoperative synchronous radiotherapy and chemotherapy after Mile＇s operation on rectal carcinoma of Dukes C stage can ensure a lower local recurrence,a higher 5-year survial rate and a similar rate of distant metastasis compared with alone chemotherapy.