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目的探讨联合术前放化疗对T3~T4分期低位直肠癌患者的临床价值。方法选择2006年1月~2009年12月T3~T4分期低位直肠癌患者102例,随机分为两组,A组52例术前联合放化疗;B组50例直接手术。术前放疗总剂量为30 Gy,每周5次,每次3 Gy,放疗开始第1周即予奥沙利铂+5-氟尿嘧啶(5-Fu)+四氢叶酸化疗,放疗结束2周后手术。结果 A组患者均耐受放、化疗并完成治疗计划;A组保肛率大于B组(67.3%vs.48.0%,P<0.05);A组术后病理分期低于B组(P<0.05)。结论低位直肠癌术前放化疗安全可靠,可提高保肛手术成功率,改善患者预后及生活质量。
Objective To explore the clinical value of combined preoperative radiotherapy and chemotherapy for low rectal cancer in T3~T4 stage. Methods One hundred and two patients with low rectal cancer from January 2006 to December 2009 were randomly divided into two groups. 52 patients in group A received preoperative radiotherapy and chemotherapy; 50 patients in group B received direct surgery. The total dose of preoperative radiotherapy was 30 Gy, 5 times per week, 3 Gy each time. Radiotherapy with oxaliplatin+5-fluorouracil (5-Fu) plus tetrahydrofolate was started in the first week of radiation therapy. surgery. Results All the patients in group A tolerated radiotherapy and chemotherapy and completed the treatment plan. The sphincter preservation rate in group A was greater than that in group B (67.3% vs. 48.0%, P<0.05). The pathological stage in group A was lower than that in group B (P<0.05). ). Conclusion Preoperative radiotherapy and chemotherapy for low rectal cancer is safe and reliable. It can improve the success rate of sphincter preserving operation and improve the prognosis and quality of life of patients.