摘要
目的:比较术前同步放化疗与术后同步放化疗对中低位直肠癌的临床疗效和毒性反应。方法:中低位局部晚期直肠癌36例行术前同步放化疗,同期41例先行根治术再行术后同步放化疗,术前和术后放射治疗的剂量为45-50Gy,分次剂量为1.8-2Gy/d,每周5 d。自放疗开始,给予5-Fu 400 mg/m2持续静脉泵入和CF200 mg静脉滴注,d1-4和d15-19。比较两组的临床疗效和毒性反应。结果:术前同步放化疗的保肛率明显高于术后同步放化疗组,而局部复发率和急性放射性消化道反应明显低于术后同步放化疗组(P<0.05)。术后的并发症和生存率在两组之间没有差别(P>0.05)。结论:中低位直肠癌术前同步放化疗可以提高保肛率,降低局部复发率和急性放射性消化道反应,值得临床推广。
Objective To compare the advantages of preoperative chemoradiotherapy with postoperative Chemoradiation mid-low locally advanced stage rectal cancer.Methods seventy-seven patients with mid-low locally advanced stage rectal cancer were randomly divided into two groups:Preoperative Chemoradiation group(n = 36) and postoperative Chemoradiation group(n = 41),receiving standard fluorouracil-based combined modality treatment,consisting of radiotherapy of 45-50 Gy plus infusional fluorouracil(400 mg/m2 days 1-4 and 15-19)and leucovorin(200 mg days 1-4 and 15-19).The survival rate,the sphincter-saving rate in operation,incidence and degree of acute side reaction of chemo-radiotherapy were compared between two groups.Results Compared with postoperative Chemoradiation group,the sphincter-saving rate in Preoperative Chemoradiation group significantly increased(P<0.05),but local recurrence rate and acute side reaction of gastrointestinal tract were significantly decreased(P<0.05),no significant difference in survival rates and postoperative complication between two groups(P>0.05).Conclusion Chemo-radiotherapy in Preoperative Chemoradiation was able to increasing the sphincter-saving rate,reducing local recurrence rate and t acute side reaction of gastrointestinal tract,which was worth of clinic generalization.
出处
《湖南师范大学学报（医学版）》
2012年第3期78-80,92,共4页
Journal of Hunan Normal University(Medical Sciences)
关键词
直肠癌
术前放化疗
术后放化疗
carcinoma of rectum
preoperative chemoradiotherapy
postoperative Chemoradiation
