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目的探讨术前放疗配合化疗治疗中晚期直肠癌的临床价值。方法73例Ⅱ-Ⅲ期直肠癌患者被随机分为两组。试验组为术前放疗配合化疗组;对照组为术前化疗组。结果两组均可使直肠癌发生坏死,降低肿瘤分期,甚至达到病理性CR,但是治疗组比对照组更能提高肿瘤降级率、病理CR率、保肛率,同时降低复发率(P<0.05)。然而该治疗并不能改善患者5年总的生存率和无病生存率,也不增加3P4毒性反应(P>0.05)。结论术前放疗配合化疗可以降低肿瘤分期,缩小肿瘤浸润范围,减少直肠癌病人术后的局部复发及提高低位直肠癌手术的保肛率,是一种安全有效的治疗。
Objective To investigate the clinical value of preoperative radiotherapy combined with chemotherapy in the treatment of advanced rectal cancer. Methods 73 patients with stage Ⅱ-Ⅲ rectal cancer were randomly divided into two groups. The experimental group was preoperative radiotherapy with chemotherapy group; the control group was preoperative chemotherapy group. Results Both of the two groups could cause necrosis of rectal cancer, reduce the tumor staging and even achieve pathologic CR, but the treatment group could improve the rate of tumor degradation, pathologic CR, anal sphincter preservation and the relapse rate (P <0.05) ). However, this treatment did not improve 5-year overall survival and disease-free survival, nor did it increase 3P4 toxicity (P> 0.05). Conclusions Preoperative radiotherapy combined with chemotherapy can reduce tumor staging, reduce the scope of tumor invasion, reduce the local recurrence of rectal cancer patients after operation and improve the anal sphincter preservation rate in low rectal cancer surgery. It is a safe and effective treatment.