论文部分内容阅读
目的:评价直肠癌术前改良短程放化疗与经典长程放化疗临床疗效及安全性。方法中下段局部晚期直肠癌按治疗方法分组,30例行改良短程放化疗(短程组),45例行经典的长程放化疗(长程组)。改良短程放疗剂量30Gy,3Gy/次,5次/周,共10次;同步化疗方案希罗达850mg/m2,一天两次口服,第1~14天,休息2~3周手术;长程放化疗组处方剂量45Gy,1.8Gy/次,5次/周,共25次;同步化疗方案为希罗达850mg/m2,一天两次口服,第1~14天和第22~35天,休息4~6周手术。结果:短程组和长程组总有效率分别为83.3%(25/30)和90.6%(29/32);T降期率分别为73.3%(22/30)、75.0%(22/32);N降期率分别为40.0%(12/30)、43.8%(14/32);保肛率分别为76.7%(23/30)、78.1%(25/32),差异均无统计学意义(P>0.05)。短程组和长程组在新辅助放化疗后出现的骨髓抑制、放射性皮炎、放射性肠炎等不良反应中的差异无统计学意义(P>0.05)。短程组和长程组在术后出现吻合口瘘、肠梗阻、会阴伤口延期愈合等并发症的发生率差异无统计学意义(P>0.05)。结论改良短程放化疗和长程放化疗均可作为直肠癌术前新辅助治疗方案,且术前改良短程放化疗有治疗周期短、住院时间短、费用相对低、患者易接受等优势。
Objective: To evaluate the clinical efficacy and safety of preoperative modified short-course radiotherapy and classical long-term radiotherapy. Methods The middle and lower distal rectal cancer were divided into groups according to the method of treatment. Thirty patients underwent modified short-course radiotherapy (short-term group) and 45 patients underwent classic long-term radiotherapy (long-term group). A total of 10 Gy, 3Gy / times, 5 times / week, 10 times; Radiotherapy of Xeloda 850mg / m2, twice a day orally, 1 ~ 14 days, rest 2 to 3 weeks surgery; Long-term radiotherapy and chemotherapy Group prescription dose 45Gy, 1.8Gy / times, 5 times / week, a total of 25 times; synchronous chemotherapy regimen for Xeloda 850mg / m2, twice daily oral administration, on days 1-14 and 22-35 days, rest 4 ~ 6 weeks surgery. Results: The total effective rates of short - term group and long - term group were 83.3% (25/30) and 90.6% (29/32), respectively. The T falling rates were 73.3% (22/30) and 75.0% (22/32), respectively. N down rates were 40.0% (12/30) and 43.8% (14/32), respectively. The rates of anal sphincter preservation were 76.7% (23/30) and 78.1% (25/32) respectively, with no significant difference P> 0.05). No significant differences were found in the adverse reactions such as myelosuppression, radiodermatitis and radiation enteritis in the short-term and long-term groups after neoadjuvant radiochemotherapy (P> 0.05). There was no significant difference in the incidence of complications such as anastomotic fistula, intestinal obstruction, and perineal wound healing between the short-term group and the long-term group after operation (P> 0.05). Conclusion Both modified and long-term radiotherapy and chemotherapy can be used as a neoadjuvant treatment for rectal cancer, and the advantages of preoperative amelioration of short-term radiotherapy and chemotherapy are: short treatment period, short hospital stay, relatively low cost and patient acceptance.