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背景与目的提高进展期低位直肠癌的根切率和保肛率是一个难题,本研究探讨术前联合放化疗(新辅助治疗)在进展期低位直肠癌中的疗效。方法23例进展期低位直肠癌患者,按术前评价均需行腹-会阴联合切除术的患者进行术前联合放化疗。放疗每周5d,每次200cGy,共4周20次,总剂量4000cGy。化疗的给药方式以放疗期间持续静脉滴注,采用草酸铂(Oxa)130mg/(m2·d1),5-FU500mg/(m2·d1-5),加CF300mg/(m2·d1-5),休息4~6周进行手术。结果15例的病例肿瘤分期降级,施行了保留肛门的直肠癌根治术,保肛率达65%(15/23),其中82%的患者肛门括约肌功能良好。结论进展期低位直肠癌的患者在接受新辅助治疗后,能使肿瘤降期,切除率增加,提高保肛率,同时副反应轻,患者依顺性较好。
BACKGROUND & OBJECTIVE: To investigate the effect of preoperative chemoradiotherapy (neoadjuvant therapy) in the treatment of advanced low rectal cancer. Methods Twenty - three patients with advanced low rectal cancer undergoing preoperative chemoradiotherapy were treated with preoperative chemoradiotherapy combined with radiotherapy for patients undergoing combined abdominal - perineal resection. Radiotherapy 5d, 200cGy per week, a total of 4 weeks 20 times, the total dose of 4000cGy. The mode of administration of chemotherapy was continuous intravenous drip during radiotherapy. Oxalate 130mg / (m2 · d1), 5-FU500mg / (m2 · d1-5) and CF300mg / (m2 · d1-5) Rest for 4 to 6 weeks for surgery. Results The tumor of 15 cases was staged in stages, and the radical rectal cancer preserving anus was performed. The anus retention rate was 65% (15/23), of which 82% had anal sphincter function well. Conclusions Patients with advanced low rectal cancer after receiving neoadjuvant therapy can reduce the tumor size, increase the resection rate, and increase the rate of anal sphincter. At the same time, the side effects are mild and the patient’s compliance is good.