目的 探讨局部晚期直肠腺癌患者术前新辅助短期高剂量术前放疗(5×5 Gy)方案对患者术后早期并发症的影响.方法 选择2017年1月至2018年6月在中国科学院大学附属肿瘤医院浙江省肿瘤医院就诊且行手术治疗的局部晚期直肠腺癌患者120例,按照随机数字表法将其分为研究组和对照组,各60例;研究组术前接受新辅助放疗(25 Gy,5次分割),1周之后手术治疗;对照组在肿瘤确诊后立即手术治疗;比较两组的手术相关指标及术后的并发症、生活功能等情况.结果 研究组9例(15.0％)观察到完全病理反应(即肿瘤标本中未发现癌细胞),12例(20.0％)发现显微镜下残留癌.研究组与对照组术中括约肌保留率分别为100.0％(60/60)、83.3％(50/60),差异有统计学意义(P=0.002);研究组转移造口率显著高于对照组[11.7％(7/60)比5.0％(3/60)],差异有统计学意义(P=0.017).所有转移造口病例均于术后3～6个月闭合;组间术后并发症发生率比较差异无统计学意义(P＞0.05),主要吻合口瘘的概率亦基本一致;生活功能分析结果显示研究组患者在整体健康状态、角色功能及社会功能方面显著优于对照组.结论 局部晚期直肠癌的术前短期治疗不会增加术后并发症的发生风险,可提高括约肌的手术保留概率.“,”Objective To investigate the effect of preoperative neoadjuvant short-term high-dose preoperative radiotherapy (RT) (5 × 5 Gy) on early postoperative complications in patients with locally advanced rectal adenocarcinoma.Methods The study period was January 2017 to June 2018.The total number of patients with locally advanced rectal adenocarcinoma who were treated in Cancer Hospital of the University of Chinese Academy of Sciences Zhejiang Cancer Hospital was 120 patients.They were divided into study group and control group according to the random number table method,60 patients in each group;the study group received neoadjuvant radiotherapy (25 Gy,5 divisions) before surgery,one week after surgery;the control group was treated immediately after tumor diagnosis;the surgical related indicators and postoperative complications,life function of the two groups were compared.Results In the study group,complete pathological reactions were observed in 9 patients (15.0％) (no cancer cells were found in tumor specimens),and 12 patients (20.0％) found residual cancer under the microscope;intraoperative sphincter retention study group and control group was 100.0％(60/60),83.3％(50/60)100％,there was significant difference (P =0.002).Patients in the study group were significantly more likely to have metastasis than the control group [11.7％(7/60) vs.5.0％(3/60)] (P=0.017).All metastasis oral cases were closed within 3-6 months after operation.There was no significant difference in the incidence of postoperative complications between the two groups,and the odds of primary anastomotic leakage was also basically the same.Life function analysis showed that the study group patients were significantly better than the control group in terms of overall health status,role function and social function.Conclusions Preoperative short-term RT in locally advanced rectal cancer does not increase the risk of postoperative complications and increase the chance of surgical preservation of the sphincter.