近年来晚期直肠癌主张综合治疗,重视术前放疗。我科1985年7月～1989年12月共收治晚期直肠癌40例,以入院先后随机分为两组,术前放疗组20例.单纯手术组20例。男26例,女14例。年龄27岁～64岁。治疗前两组肿瘤基底部均固定,临床检查认为不能手术切除。术前放疗后使5例Dukes C期转变为 B期。术前放疗采用~(60)钴或10MV直线加速器照射,初期采用矩形射野,后改用凸形射野,上起第二腰椎中点下至肛缘,两侧至小骨盆缘,包括原发病灶及1、2、3站引流淋巴结,放射剂量4000～5000cGy/4～5周。放疗后肿瘤消失2例,肿瘤缩小>1/2 5例,<1/27例,无变化6例。鳞癌,低分化腺癌,管状腺癌缩小明显。而粘液腺癌,印戒细胞癌较差。放疗组行根治性切除8例,姑息性切除2例,结肠造瘘8例;单纯手术组根治性切除2例,姑息性切除3例,结肠造瘘15例。放疗组根 In recent years, advanced rectal cancer advocates comprehensive treatment and emphasis on preoperative radiotherapy. In our department from July 1985 to December 1989, a total of 40 cases of advanced rectal cancer were treated and were randomly divided into two groups by admission. 20 cases were preoperative radiotherapy and 20 cases were simple surgery. There were 26 males and 14 females. Age 27 to 64 years old. Before treatment, the basement of both groups of tumors was fixed, and clinical examination suggested that they could not be surgically removed. After preoperative radiotherapy, 5 cases of Dukes C were converted to B. Preoperative radiotherapy was performed with a ~(60) cobalt or 10 MV linear accelerator, initially using a rectangular field, and then using a convex field, with the second lumbar spine midpoint down to the anal margin and both sides to the small pelvic margin, including the original Lesion and lymphatic drainage at 1, 2 and 3 stations, radiation dose 4000 ~ 5000cGy / 4 ~ 5 weeks. After radiotherapy, the tumor disappeared in 2 cases, tumor shrinkage was >1/2 5 cases, <1/27 cases, and no change in 6 cases. Squamous cell carcinomas, poorly differentiated adenocarcinomas, and tubular adenocarcinomas shrink significantly. The mucinous adenocarcinoma, signet ring cell carcinoma is poor. Radiotherapy group underwent radical resection in 8 cases, palliative resection in 2 cases, and colostomy in 8 cases; radical surgery in 2 cases, palliative resection in 3 cases, and colostomy in 15 cases. Radiotherapy group root