【摘要】 目的探讨直肠癌根治术术前卡培他滨联合三维适形放疗对患者TNM分期、保肛、手术并发症及生存情况影响。方法随机数字表法将46例直肠癌手术治疗患者分为观察组和对照组,每组23例,对照组患者术前接受单纯放疗,观察组患者术前接受同步放化疗,两组均于放疗结束后间隔6～8周实施直肠癌根治手术。比较两组患者术前放化疗的有效率及术后TNM分期降期率;比较两组患者一般手术指标、术后并发症发生率及保肛率;随访1年,比较两组患者的生存率。结果观察组患者术前放化疗的总有效率为82.61%,高于对照组患者的52.17%,差异有统计学意义(P﹤0.05);观察组患者术后降期率为73.91%,高于对照组患者的43.48%,差异有统计学意义(P﹤0.05)。两组患者一般手术指标、并发症发生率和术后1年生存率比较,差异均无统计学意义(P﹥0.05)。观察组患者的保肛率为95.65%,高于对照组患者的73.91%,差异有统计学意义(P﹤0.05)。结论直肠癌根治术前卡培他滨联合三维适形放疗可提高患者的临床疗效,在一定程度上提高降期率和保肛率,且不增加术后并发症发生率。更多还原

【Abstract】 Objective To explore the clinical effect of preoperative capecitabine combined with three-dimensional conformal radiotherapy on the TNM staging, anal preservation, surgical complications and survival rate in patients undergoing radical resection for rectal cancer. Method A total of 46 patients with rectal cancer receiving radical resection were enrolled and divided into observation group and control group with 23 cases in each group using a random number table. Patients in the control group received radiotherapy singly before surgery while patients in the observation group received concurrent radiotherapy and chemotherapy before surgery. Both groups received radical resection for rectal cancer at an interval of 6 to 8 weeks after radiotherapy. The response rate of preoperative radiotherapy and chemotherapy and postoperative TNM staging and downgrading rate between the two groups were compared. The general surgical indicators, postoperative complications and anal preservation rate between the two groups were also compared. Overall survival of the two groups were compared after 1-year follow-up. Result The total response rate of preoperative radiotherapy and chemotherapy in the observation group was 82.61%, which was higher than 52.17% in the control group, and the difference was statistically significant(P<0.05). The postoperative downgrading rate of the observation group was 73.91%,which was higher than 43.48% of the control group, and the difference was statistically significant(P<0.05). There were no statistically significant differences in general surgical indicators, complication rates, and 1-year survival rates between the two groups(P>0.05). The anal preservation rate of the observation group was 95.65%, which was higher than 73.91%of the control group, and the difference was statistically significant(P<0.05). Conclusion Capecitabine in combination with three-dimensional conformal radiotherapy before radical resection for rectal cancer could improve the clinical effect of patients, and increase the rate of downgrading and anus preservation to a certain degree without increasing the incidence of postoperative complications.更多还原