三维适形放射配合化疗治疗局部晚期和术后复发性直肠癌

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1、维普资讯http://www.cqvip.com中华放射肿瘤学杂查生旦笙鲞笙塑』!!oJ!·3l··论著·三维适形放射配合化疗治疗局部晚期和术后复发性直肠癌何晓军吴志军万志龙蔡晶【摘要】目的探讨局部晚期和术后复发性直肠癌三维适形放射治疗(3DCRT)配合化疗的临床疗效。方法24例局部晚期和术后复发性直肠癌均在外照射44Gy后进入3DCRT，采用3DCRT结合氟尿嘧啶为主型同步化疗(综合组)11例，单独应用3DCRT(对照组)13例。结果综合组和对照组疼痛缓解率分别为90．9％和84．6％，有效(cR+PR)率分别为9

2、0．9％和69．2％，2个组差异均无显著性意义(P值均>0．05)。2个组2年生存率分别为63．6％、38．5％，生存率比较综合组优于对照组(=6．12，P：0．013)；2年局部控制率分别为72．7％、61．5％，差异无显著性意义(X2=3．74，P=0．053)；远地转移率分别为36．3％、61．5％，差异有极显著性意义(=7．39，P=0．007)。在毒副反应方面2个组相似(P>0．05)。结论局部晚期和术后复发性直肠癌临床行外放射+三维适形放射治疗配合化疗可明显减少远地转移率和提高患者的近期生存率。【关键词】

3、直肠肿瘤／放射疗法；放射疗法，适形；直肠肿瘤／化学疗法Threedimensional-eonformalradiotherapycombhmdwithchemotherapyforlocallyadvancedorrecurrentrectad{~BicerHEXia~jun，WUZhi-jun．一long，cJing．Depol"tmerrtofRadiationOncology，uNantongTumorHospital，Nan,tong2261，Chi，lⅡ【Abstract】ObjectiveTostudy

4、theoutcomeoflocallyadvancedorrecurrentrectalcancertreatedbythreedimensionalconformalradiothempy(3D—CRT)combinedwitl1chemothempy(CT)．MethodsTwenty—fourpatientswitl1localyadvaBeedorrecurrentrectalcancerwereirradiatedbyexternalbeamradiothempytoatotaldoseof44Gv，the

5、nrandomizedtoreceive3D—CRTpluscI1(combinedgroup)or3D—CRTalone(controlgroup)，withl1patientsintheformerand13intl1elatter．Thechemothempyregimenincluded5一FlJandCF．ResultsThepain-alleviationrateswere90．9％and84．6％，whiletheoverallresponse(CR+PR)rateswere90．9％and69．2％i

6、ntl1ecombinedandcontrolgroup，withthediferenceinsignificant(P>0．05)．Yet，fortl1ecombinedandcontrolgroups．the2-yearsurvivalrateswere63．6％and38．5％，witl1tl1edifereneesignificant(P=0．013)．rhe2-year1OCalcontrolrateswere72．7％and61．5％．withtl1edifereneeinsignificant(P=0．

7、053)．The2-yeardislantmetastasisrateswere36．3％and61．5％，witl1thediferencesignificant(P=0．007)．Thesideefectsweresimilarintl1etwogroups(P>0．05)．CondusionsConventionalradiotherapyplusthreedimensionaleonformalmdiothempycombinedwithehemothemWmaysignificantlyimpmvethes

8、urvivalrateandreducetl1edislantmetastasisrateoflocallvadvancedorrecurrentrectalcancer．【Keywords】Rectalneoplasms／mdiothempy；Radiotherapy，co~ormal；Rectalneoplasms／ehemothempy自