【作者】 孙光绮； 王瑞芝； 李明淑；

【Author】 Guang Qi Sun. Rui Zhi Wang. MingShu Li The 3 rd clinical college of Harbin Medical University

【机构】 哈尔滨医科大学第三临床医学院；

【摘要】 目的文献报导放射治疗对盆腔内复发直肠癌治疗,有减轻症状,延长生存作用,但较为理想的剂量和分割方法未有定论。本文回顾性分析,以探讨放射治疗对复发直肠癌治疗效果。方法 44例复发直肠癌,13例外院手术,术后病理分期不详,余31例B期17例,C期13例, A期1例。第一次做miles术25例,占56.8％;2年内复发占81.8％。44例中19例做手术切除,25 例放射治疗,剂量40—70Gy,常规分割方法。结果照射后会阴部疼痛,出血症状均有减轻,仍至消失,会阴部肿块照射后缩小1／2以上者占55％(5／9)。随诊结果放疗组1年生存52％,3年生存16％,好于手术的42.1％、10.5％。结论直肠癌术后2年内应密切观察,以早期发现复发病例,早期治疗;对术后有高危险复发的病例应做术后放疗。放射治疗在直肠癌术后复发的治疗中起到减轻症状,使肿瘤缩小,延长生存作用;照射剂量不宜低于60Gy。更多还原

【Abstract】 Subject: It is reported that radiotherapy may relieve the signs and prolong the life time of the pelvic recurrence of rectal cancer patients, but the iceal dosage and fractions could not be concluded. This paper diceusses the effect of irradiation on pelvic recurrence through retro- spective analysis. Method It included 44 rectal cancer recurrence patients in which 13 cases were operated outside our hospital without postoperative pathological stage, the others 1 case with A stage,17 cases with B stage and 13 cases with C stage. 25 cases, 56.8％ in all the patients, were given Miles’ operation at the first treatment who suffered recurrence within 2 years. After recurrence, 19 cases took operations and the othe 25 After recurrence, 19 cases took operations and the other 25 cases were given irradiation 40—70Gy in normal fractions. Result After irradiation, the perineal pain and the hemorrhage relieved or disappeared, and the 55％ perineal blocks decreased less than 1/2 primary volume (5/9). The follow—up showed the result of the radiotherapy group was better than that of the operation group, the one year sur- vival rate is 52％ and 42％ respectively and the three year survival rate is 16％ and 10.5％ respec- tively. Conclusion That close observe to find and treat the recurrence earlier must be done in the following two years after operation and the cases with high recurrence risk should be given post- operative irradiation. Radiotherapy can surely reliveve the signs, decrease the cancer volume and prolong the life time but the dose should not be less than 60Gy.更多还原