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目的探讨早期低位直肠癌局部切除术后加与不加放疗的疗效。方法回顾性分析2002年1月-2007年12月间进行局部切除术的56例早期低位直肠癌患者资料,其中29例为术后放疗同步给予氟尿嘧啶为基础的化疗。采用Kaplan-Meier进行生存分析,差异性检验采用Log rank法,组间比较采用χ2检验。结果 5年无病生存率局部切除术组和局部切除术联合放疗组分别为66.7%和89.7%,两组之间差异有统计学意义(χ2=4.469,P=0.035)。局部切除术组的5年局部复发率和5年总生存率为25.9%和74.1%,局部切除术联合放疗组为6.9%和93.1%,两组接近有统计学意义水平(χ2=3.75,P=0.053;χ2=3.638,P=0.056)。结论对于早期低位直肠癌,局部切除术联合辅助放疗是一个可供选择和可行的治疗技术。
Objective To investigate the effect of local radiotherapy with or without radiotherapy for early low rectal cancer. Methods The data of 56 patients with early stage rectal cancer undergoing partial resection from January 2002 to December 2007 were retrospectively analyzed. Among them, 29 patients received concurrent fluorouracil-based chemotherapy after radiotherapy. Survival analysis was performed using Kaplan-Meier, Log rank test was used for difference test, and Chi-square test was used for comparison between groups. Results The 5-year disease-free survival rate was 66.7% and 89.7% in the local resection group and the local excision combined radiotherapy group, respectively. There was a significant difference between the two groups (χ2 = 4.469, P = 0.035). The 5-year local recurrence rate and 5-year overall survival rate were 25.9% and 74.1% in the local resection group and 6.9% and 93.1% in the local excision combined with radiotherapy group, respectively, with statistical significance (χ2 = 3.75, P = 0.053; χ2 = 3.638, P = 0.056). Conclusions Local resection combined with adjuvant radiotherapy is an alternative and feasible treatment for early low rectal cancer.