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目的比较三维适形放疗与常规放疗对直肠癌术后患者的近远期疗效。方法术后需行放疗的直肠癌根治患者60例,随机分成三维适形放疗组(A组,31例)和常规放疗组(B组,29例),比较不良反应、近远期并发症及1、2、3年生存率。结果 A组直肠反应发生率35.48%,低于B组的62.07%(P<0.05);A组膀胱反应发生率16.13%,低于B组的41.38%(P<0.05)。A组放射性直肠炎发生率12.90%,低于B组的37.93%(P<0.05);A组放射性膀胱炎发生率9.68%,低于B组的31.03%(P<0.05)。A组的1、2、3年生存率分别为96.77%、83.87%、74.19%,略高于B组的89.65%、79.31%、68.96%(P>0.05)。结论三维适形调强治疗技术能显著减少术后放疗引起的近远期并发症;但在提高远期生存率方面未见明显优势。
Objective To compare the short-term and long-term effects of three-dimensional conformal radiotherapy and conventional radiotherapy on postoperative patients with rectal cancer. Methods Sixty patients with rectal cancer underwent radiotherapy were randomly divided into three-dimensional conformal radiotherapy group (group A, n = 31) and conventional radiotherapy group (group B, n = 29). The adverse reactions, 1, 2, 3 year survival rate. Results The incidence of rectal reaction in group A was 35.48%, lower than that in group B (62.07%, P <0.05). The incidence of bladder reaction in group A was 16.13%, which was lower than that in group B (41.38%, P <0.05). The incidence of radiation proctitis in group A was 12.90%, lower than that in group B (37.93%, P <0.05). The incidence of radiation cystitis in group A was 9.68%, which was lower than that in group B (31.03%, P <0.05). The 1-year, 2-year and 3-year survival rates of group A were 96.77%, 83.87% and 74.19%, respectively, slightly higher than that of group B (89.65%, 79.31%, 68.96%, P> 0.05). Conclusion Three-dimensional conformal IMRT can significantly reduce the short-term and long-term complications caused by postoperative radiotherapy; however, there is no obvious advantage in improving the long-term survival rate.