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目的探讨新辅助单纯放疗和新辅助同期放化疗两种治疗方式在局部晚期直肠癌中的临床疗效。方法回顾性分析我院自2009年1月至2012年1月收治的58例直肠癌患者,其中对照组给予新辅助单纯放疗组30例,给予盆腔外照射,及观察组给予新辅助同期放化疗28例,给予盆腔外照射,同期口服卡培他滨。比较两组的疗效、保肛情况、复发率、毒性反应。结果两组有效率分别为78.6%(22/28),43.3%(13/30)(P<0.01)。两组患者保肛率为46.4%(13/28),26.7%(8/30)(P<0.05);两组局部复发率为7.1%(2/28),16.7%(5/30)(P<0.05)。对照组I-Ⅱ级毒性反应总发生率为73.3%(22/30),Ⅲ-Ⅳ级为26.7%(8/30),观察组I-Ⅱ级毒性反应总发生率为64.3%(18/28),Ⅲ-Ⅳ级为35.7%(10/28)(P>0.05)。结论新辅助同期放化疗治疗局部晚期具有更高的临床有效率,提高保肛率和长期生存率,毒副反应小,值得临床推广。
Objective To investigate the clinical efficacy of neoadjuvant radiotherapy and neoadjuvant chemoradiotherapy in locally advanced rectal cancer. Methods Retrospective analysis of 58 patients with rectal cancer admitted to our hospital from January 2009 to January 2012, the control group were given neoadjuvant simple radiotherapy group 30 cases, given pelvic external irradiation, and the observation group given neoadjuvant concurrent chemoradiotherapy 28 cases, given pelvic external irradiation, simultaneous oral capecitabine. The curative effect, anal sphincter preservation, recurrence rate and toxicity were compared between the two groups. Results The effective rates of the two groups were 78.6% (22/28) and 43.3% (13/30), respectively (P <0.01). The anal sphincter rate was 46.4% (13/28) and 26.7% (8/30) in both groups (P <0.05). The local recurrence rates were 7.1% (2/28) and 16.7% (5/30) in both groups P <0.05). The total incidence of grade I-II toxicity was 73.3% (22/30) in control group, 26.7% (8/30) in grade III-IV, and 64.3% (18.3% 28), grade Ⅲ-Ⅳ was 35.7% (10/28) (P> 0.05). Conclusions Neoadjuvant concurrent chemoradiotherapy is more effective in locally advanced stage, improving anal sphincter preserving rate and long-term survival rate, with less toxic side effects and worthy of clinical promotion.