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目的探讨新辅助放疗在低位局部进展期直肠癌中的疗效及其对保肛手术的意义。方法回顾性分析2000~2005年39例行新辅助放疗低位直肠癌病人的临床资料。结果肿瘤距肛缘3~7 cm,平均4.9 cm。放疗后21例(53.8%)排便困难、便血等症状得以改善。腹会阴联合切除14例,低位前切除术13例,Parks术8例,Hartm ann术4例。术后病理显示肿瘤完全消退(CR)3例,肿瘤部分缓解(PR)22例,无效(NR)14例,总有效率为64.1%(25/39)。保肛率为53.8%(21/39),其中放疗有效者(CR+PR)保肛率为64%(16/25),无效者为35.7%%(5/14),两者间差异有显著性意义(P<0.01)。结论新辅助放疗对多数直肠癌病人有效,可以使肿瘤缩小、降低分期,并可提高低位直肠癌的保肛率。
Objective To investigate the effect of neo-adjuvant radiotherapy in the treatment of locally advanced rectal cancer and its significance for sphincter preserving surgery. Methods The clinical data of 39 patients with neoadjuvant radiation therapy for rectal cancer underwent resection from 2000 to 2005 were retrospectively analyzed. Results The tumor from the anal verge 3 ~ 7 cm, an average of 4.9 cm. After radiotherapy, 21 cases (53.8%) had difficulty in defecation and symptoms such as hematochezia were improved. Abdominal perineal resection in 14 cases, 13 cases of low anterior resection, Parks surgery in 8 cases, Hartm ann surgery in 4 cases. Postoperative pathology showed complete tumor regression (CR) in 3 cases, tumor partial response (PR) in 22 cases and ineffective (NR) in 14 cases, with a total effective rate of 64.1% (25/39). The rate of anus retention was 53.8% (21/39). The effective rate of CR + PR was 64% (16/25) and 35.7% (5/14), respectively Significant significance (P <0.01). Conclusions Neo-adjuvant radiotherapy is effective in most patients with rectal cancer, which can reduce the size of the tumor, reduce the staging, and improve the rate of anus retention in low rectal cancer.