【摘要】 目的探析术前调强适形放疗对局部晚期直肠癌临床疗效的影响。方法选择我院2010年1月~2013年10月收治93例局部晚期直肠癌患者进行回顾性分析,根据治疗方式分为新辅助放疗组(52例)与手术组(41例)。新辅助放疗组于术前予以调强适形放疗,之后予以手术,手术组直接行根治术。比较两组临床完全缓解率(cCR)、病理完全缓解率(pCR)、2年无病生存率(DFS)、总生存率(OS)、并发症发生率及治疗前后KPS评分。结果新辅助放疗组cCR、pCR、DFS、OS分别为15.4%(8/52)、9.6%(5/52)、88.5%(46/52)、98.1%(51/52),均高于手术组,差异有统计学意义(P<0.05),提示近、远期疗效均更佳。新辅助放疗组并发症发生率为11.5%(6/52),明显低于手术组29.3%(12/41),差异P<0.05。两组治疗前KPS评分的差异(P>0.05),治疗后新辅助放疗组KPS评分升高至(88.3±4.3)分,高于手术组(83.7±3.9)分,差异有统计学意义(P<0.05)。结论术前调强适形放疗治疗局部晚期直肠癌利于破坏肿瘤氧供、缩小瘤体,可大幅提高病理学缓解率并减少术后并发症,利于远期疗效提高。更多还原

【Abstract】 Objective To explore the effect of preoperative intensity modulated radiotherapy on the pathological remission rate and complications of locally advanced rectal cancer. Methods 93 cases of patients with locally advanced rectal cancer who were admitted in our hospital between January 2010 and October 2013 were retrospectively analyzed. According to the treatment methods, they were divided into the neoadjuvant radiotherapy group(52 cases) and the operation group(41 cases). The neoadjuvant radiotherapy group was treated by intensity modulated radiotherapy before operation. Then they were treated with operation. The operation group was directly treated with radical operation. The clinical complete remission rate(c CR), pathological complete remission rate(p CR), 2-year disease-free survival rate(DFS), overall survival rate(OS), incidence rate of complications and KPS scores before and after treatment were compared between the two groups. Results CCR, p CR, DFS and OS in the neoadjuvant radiotherapy group [15.4%(8 / 52), 9.6%(5/52), 88.5%(46 / 52), 98.1%(51 / 52)] were significantly higher than those in the operation group(P < 0.05), indicating that the short-term and long-term curative effects were better. The incidence of complications in the neoadjuvant radiotherapy group [11.5%(6/52)]was significantly lower than that in the operation group [29.3%(12/41)](P < 0.05). The difference of KPS score between the two groups before treatment was not significant(P > 0.05). After treatment, KPS score of the neoadjuvant radiotherapy group was increased to(88.3±4.3) which was higher than that in the operation group [(83.7±3.9)](P < 0.05). Conclusions To adopt preoperative intensity modulated radiotherapy in the treatment of locally advanced rectal cancer is beneficial to the destruction of tumor oxygen supply and the reduction of tumor volume,which can significantly improve the pathological remission rate and reduce postoperative complications. It is beneficial to the improvement of long-term curative effect.更多还原