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目的评价局部晚期直肠癌术前放化疗的效果及毒副作用。方法对16例局部晚期直肠癌患者行术前放化疗,放疗总剂量为45Gy,每周5次,每次1．8Gy。同时配合全身化疗,方案:亚叶酸钙(CF)100mg,静脉滴注,随后静脉给予5-氟脲嘧啶(5-FU)300mg/m2,第1-5天,第22-26天,共2个周期,放化治疗完成后4-6周行手术治疗。结果术前放化治疗后T分期下降10例(62．50％),N分期下降8例(50．00％),降低临床分期率为56．25％(9/16),总有效率为68．75％(11/16)。根治性切除16例(100．00％)。随访14例未发现局部复发、远处转移及死亡病人。9例保肛术病人肛门括约肌功能正常。结论术前放化疗可缩小原发肿瘤体积,减少局部淋巴结转移率,降低肿瘤分期,提高手术的切除率和保肛率,且毒副作用可耐受。
Objective To evaluate the effect and side effects of preoperative radiotherapy and chemotherapy in locally advanced rectal cancer. Methods Sixteen patients with locally advanced rectal cancer underwent preoperative chemoradiation. The total dose of radiotherapy was 45 Gy, which was 1.8 Gy per week. At the same time with systemic chemotherapy, program: leucovorin (CF) 100mg, intravenous infusion, followed by intravenous 5-fluorouracil (5-FU) 300mg / m2, 1-5 days, the first 22-26 days, a total of 2 A cycle, radiotherapy and chemotherapy after the completion of 4-6 weeks of surgical treatment. Results The T stage decreased 10 (62.50%), N stage decreased 8 (50.00%), and the clinical staging rate decreased 56.25% (9/16). The total effective rate was 68.75% (11/16). Radical resection in 16 cases (100.00%). Follow-up of 14 cases found no local recurrence, distant metastasis and death patients. Nine cases of anal sphincter anal sphincter function. Conclusion Preoperative chemoradiotherapy can reduce the volume of primary tumor, reduce the rate of local lymph node metastasis, reduce the tumor staging, improve the surgical resection rate and anal sphincter rate, and the side effects can be tolerated.