术前放疗与直肠癌术后局部复发的临床观察

目的:探讨直肠癌术前放疗与术后局部复发的关系.方法:直肠癌患者男536例,女226例,年龄21.73(平均48)岁;病理分型:高分化腺癌320例(42.0%),中分化腺癌195例(25.6%),黏液腺癌84例(11.0%),乳头状腺癌40例(5.2%),低分化腺癌50例(6.6%),未分化癌34例(4.5%),腺鳞癌18例(2.4%),印戒细胞癌21例(2.7%).分期:Duckes A期115例,B期399例,C期210例,D期38例.762例行手术(n=589)或手术加术前放疗(n=173)治疗.随访(58-143 mo),了解术前放疗与预后的关系.结果:在762例中,术后局部复发142例(18.6%).其中术前放疗者173例中,术后局部复发19例(11.0%),术前未进行放疗的589例中,局部复发123例(20.9%),两者比较有统计学意义(P<0.05).术前未进行放疗的5 a生存率48.1%,手术前施行放疗的5 a生存率58.4%,两者比较有统计学意义(P<0.05),结论:直肠癌术前放疗可以降低术后局部复发率,提高5 a生存率.

Clinical observation of postoperative local recurrence in rectal carcinoma treated with preoperative radiotherapy

AIM:To explore the relationship between preoperative radiotherapy in rectal carcinoma and postoperative local recurrence. METHODS:Patients with rectal carcinoma (n= 762) treated with surgery,with or without pre- operative radiotherapy,were followed-up and analyzed retrospectively for postoperative local recurrence and survival rate. RESULTS:There were 142 (18.6%) patients with postoperative local recurrence.Among these, 123 (20.9%) were not treated with preoperative radiotherapy and 19 (11.0%) were treated.There was a significantly larger difference between them (P<0.05).The 5 years survival rate was 48.1% in patients not treated with preopera- tive radiotherapy and 58.4% in those who were treated.Further,there was a significantly larger difference between them (P<0.05). CONCLUSION:Preoperative radiotherapy in rectal carcinoma can reduce local recurrence, and increase 5 year survival rate.