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目的:探讨新辅助化放疗在局部进展期低位直肠癌保留肛门括约肌中的价值．方法:2002-10／2006-02 T3,T4期低位直肠癌患者63例分为A组42例,给予放疗40—46 Gy／20—23次,5次／wk,2 Gy／次,同时给予卡培他滨1250 mg／(m2·d),分2次口服,从放疗开始连续服至手术,放疗结束后休息6 wk进行手术:B组21例,明确诊断后手术,术后给予放化疗．结果:A组按计划完成新辅助化放疗,其中5例肿瘤完全消失,未手术．37例施行根治性手术,其中33例行保留肛门括约肌手术,4例行腹会阴切除术,A组保留肛门括约肌率为89．2％．B组21例施行根治性手术,其中11例行保留肛门括约肌手术,10例行腹会阴切除术,保留肛门括约肌率为52．4％．结论:新辅助治疗能有效地使肿瘤降期缩小,使肿瘤切除率和保留肛门括约肌率明显增加．
Objective: To investigate the value of neoadjuvant chemoradiotherapy in the preservation of anal sphincter in locally advanced low rectal cancer. METHODS: From October 2006 to February 2006, 63 patients with low rectal cancer of stage T3 and T4 were divided into group A (n = 42), treated with radiation (40-46 Gy / 20-23 times, 5 times / wk, 2 Gy / time) Capecitabine 1250 mg / (m2 · d), 2 times orally, from the beginning of radiotherapy continuous operation to surgery, 6 weeks after the end of radiotherapy for surgery: group B 21 cases, clear diagnosis after surgery, postoperative radiotherapy and chemotherapy . Results: In group A, neoadjuvant radiotherapy was completed as planned. Five of the tumors disappeared completely without surgery. Thirty-seven patients underwent radical surgery, of which 33 underwent anal sphincter surgery and 4 underwent perineal resection. The anal sphincter retention rate in Group A was 89.2%. In group B, radical operation was performed in 21 cases, of which 11 cases retained anal sphincter operation and 10 cases performed abdominal perineal resection. The anal sphincter retention rate was 52.4%. Conclusion: The neoadjuvant therapy can effectively reduce the tumor down-time and make the tumor resection rate and retention anal sphincter rate significantly increased.