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目的 :分析比较直肠癌术后局部复发不同治疗方法的疗效。方法 :1986～ 1993年收治 10 1例直肠癌术后局部复发的患者 ,49例单纯放疗 (Ⅰ组 ) ,2 5例单纯手术切除 (Ⅱ组 ) ,2 7例手术切除加放疗 (Ⅲ组 )。结果 :3组局部复发率分别为Ⅰ组 77.5 %、Ⅱ组 6 0 .0 %、Ⅲ组 2 9.6 % ,以Ⅲ组局部复发率最低 (P <0 .0 1) ,局部复发加远处转移率分别为Ⅰ组85 .7%、Ⅱ组 76 .0 %、Ⅲ组 5 9.2 % ,仍以Ⅲ组为最低 (P <0 .0 5 )。 3组 1年生存率分别为Ⅰ组 5 9.2 %、Ⅱ组 84.0 %、Ⅲ组 92 .5 % ,以Ⅲ组预后最佳 (P <0 .0 5 ) ,3年生存率分别为Ⅰ组 10 .2 %、Ⅱ组 16 .0 %、Ⅲ组 33.3% ,其中Ⅰ、Ⅲ组比较 ,Ⅲ组优于Ⅰ组 (P <0 .0 5 )。结论 :局部复发直肠癌患者手术加放疗优于单纯手术切除和单纯放射治疗。
Objective: To analyze the efficacy of different treatment methods for local recurrence after rectal cancer surgery. METHODS: From January 1986 to 1993, 101 patients with local recurrence of rectal cancer were treated. 49 patients received radiotherapy alone (group I), 25 patients received surgical resection alone (group II), and 27 patients received surgery and radiotherapy (group III). . Results: The local recurrence rates in the three groups were 77.5 % in group I, 60.0% in group II, and 29.6% in group III. The local recurrence rate was lowest in group III (P < 0.01), local recurrence plus distant metastasis. The rates were 85.7% in group I, 76.0% in group II, and 59.2% in group III, still the lowest in group III (P < 0.05). The 1-year survival rates in the three groups were 59.2% in group I, 84.0% in group II, and 92.5% in group III. The best prognosis was in group III (P < 0.05), and the 3-year survival rate was in group I10. The percentages in .2%, 16.0% in group II and 33.3% in group III were compared between group I and group III, and group III was better than group I (P <0.05). Conclusion : Surgery plus radiotherapy for patients with locally recurrent rectal cancer is superior to surgery alone and radiotherapy alone.