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目的:探讨新辅助化疗结合三维适形放疗在晚期不可手术切除直肠癌转化治疗中的应用效果。方法:选取2008年1月—2013年6月收治的56例不可切除的直肠癌患者(伴肝转移12例),30例作为观察组,使用新辅助化疗加三维适形放疗;26例作为对照组,采用新辅助化疗加常规放疗。比较两组患者治疗后可切除转化率、术后生存状态、不良反应和近期并发症情况。结果:在治疗16周时观察组可切除转化率明显高于对照组(60.0%vs.26.9%,P=0.013);与对照组比较,观察组无疾病进展生存期及总生存期均明显延长(P=0.046,P=0.029);两组不良反应及近期并发症发生情况差异无统计学意义(均P>0.05)。结论:新辅助化疗结合三维适形放疗可明显提高不可手术切除直肠癌的可切除转化率,延长患者的生存期且不增加不良反应和与并发症的发生率。
Objective: To investigate the effect of neoadjuvant chemotherapy combined with three-dimensional conformal radiotherapy in the treatment of advanced unresectable rectal cancer. Methods: Fifty-six patients with unresectable rectal cancer (12 with liver metastasis) were enrolled from January 2008 to June 2013. Thirty patients were treated as neoadjuvant chemotherapy plus three-dimensional conformal radiotherapy. Twenty-six patients served as control Group, using neoadjuvant chemotherapy plus conventional radiotherapy. The resectability, postoperative survival status, adverse reactions and recent complications were compared between the two groups. Results: At the 16th week, the resectability of the observation group was significantly higher than that of the control group (60.0% vs.26.9%, P = 0.013). Compared with the control group, the progression-free survival and overall survival of the observation group were significantly longer (P = 0.046, P = 0.029). There was no significant difference in the incidence of adverse reactions and recent complications between the two groups (all P> 0.05). Conclusion: Neoadjuvant chemotherapy combined with three-dimensional conformal radiotherapy can significantly improve the resectability of unresectable rectal cancer, prolong the survival of patients without increasing the incidence of adverse reactions and complications.