摘要
目的探讨术前加速放疗联合手术治疗直肠癌的疗效及毒性反应。方法1996年9月至1998年12月对直肠癌术前加速放疗的疗效及毒性反应进行了前瞻性随机分组研究,综合组和单纯手术组各51例。术前加速放疗采用8MVX线照射,每日2次,每次2Gy,间隔6～8h,DT40Gy/20F/2周,放疗与手术间隔2～28d,中位时间为10d。结果综合组及单纯手术组1,3,5年生存率分别为98.0%、75.5%、75.5%和88.2%、63.1%、53.7%(P=0.03);综合组手术切除率为100.0%(51/51),单纯手术组为94.2%(48/51,P>0.05);综合组淋巴结转移率为15.7%(8/51),单纯手术组为35.3%(18/51,P<0.05);综合组局部复发率为11.8%(6/51),单纯手术组为43.1%(22/51,P<0.05);综合组远处转移率为15.7%,单纯手术组为11.8%(6/51,P<0.05)。结论术前加速放疗加手术综合治疗可以提高直肠癌的局部控制率和生存率,加速放疗缩短了治疗时间,急性毒性反应可以耐受,未增加手术难度和术后并发症。
Objective To evaluate the efficacy and toxicity of preoperative accelerated and hyperfractionated radiotherapy in treatment of rectal carcinoma.Methods 102 patients were divided randomly into combined group(R+S,51 patients) or surgery only(S,51 patients). The patients of R+S group received 8 MV X-irradiation D_T 40 Gy at 2 Gy twice daily, 5 days per week,and were operated 2 to 28 days after irradiation.Results The 1-,3-and 5-year survival rates were 98.0%,75.5%,75.5% in R+S group and 88.2%,63.1%,53.7% in S group(P=0.03).The resectability rates were 100% in R+S group and 94.2% in S group(P>0.05). Lymphnode metastasis were found in 15.7% in R+S group and 35.3% in S group(P<0.05). The local recurrence rates were 11.8% in R+S group and 43.1% in S group(P<0.05).Conclusions Preoperative accelerated and hyperfractionated radiotherapy is able to improve the survival rate of patients with rectal carcinoma and local control rate of the carcinoma and shorten the treatment course without increasing operative difficulty or complications. The acute toxicity can be tolerated.
出处
《中国肿瘤临床与康复》
2005年第3期215-217,共3页
Chinese Journal of Clinical Oncology and Rehabilitation
关键词
结直肠肿瘤/放射疗法
超分割放疗
Colorectal neoplasms/radiotherapy
Hyperfractionated radiotherapy
