新辅助同步放化疗联合全系膜切除对局部进展期中低位直肠癌的治疗价值

目的探讨新辅助同步放化疗联合直肠全系膜切除术（total mesorectal excision,TME）用于局部进展期中低位直肠癌治疗的可行性与临床价值。方法 111例局部进展期（T3～4 N0～2 M0）中低位直肠癌术前接受同步放化疗,放疗剂量50 Gy,化疗包括奥沙利铂＋卡培他滨的联合化疗方案及不含铂类药物的单药化疗方案。共105例患者同步放化疗结束后2～10周内完成了肿瘤根治性（R0）手术,可进行疗效的病理学评价。结果 105例患者获得根治性切除,切缘均阴性,42例（37.8%,42/111）患者成功实施保肛手术;18例临床-影像分期为T4期患者中,15例（83.3%）新辅助放化疗后获...

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Bibliographic Details
Published in肿瘤防治研究 Vol. 39; no. 8; pp. 910 - 913
Main Author 王仲照 周志祥 毕建军 张海增 周海涛 梁建伟 王征
Format Journal Article
LanguageChinese
Published 2012
Subjects
全系膜切除
化疗
放射疗法
新辅助治疗
直肠肿瘤
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ISSN1000-8578

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Summary:目的探讨新辅助同步放化疗联合直肠全系膜切除术（total mesorectal excision,TME）用于局部进展期中低位直肠癌治疗的可行性与临床价值。方法 111例局部进展期（T3～4 N0～2 M0）中低位直肠癌术前接受同步放化疗,放疗剂量50 Gy,化疗包括奥沙利铂＋卡培他滨的联合化疗方案及不含铂类药物的单药化疗方案。共105例患者同步放化疗结束后2～10周内完成了肿瘤根治性（R0）手术,可进行疗效的病理学评价。结果 105例患者获得根治性切除,切缘均阴性,42例（37.8%,42/111）患者成功实施保肛手术;18例临床-影像分期为T4期患者中,15例（83.3%）新辅助放化疗后获得根治性切除（R0）。所有患者手术及术后恢复顺利,无严重手术并发症;术后病理示肿瘤完全消退15例（14.3%）,重度消退26例（24.8%）,中度消退40例（38.1%）,轻度及无消退24例（22.8%）。结论新辅助同步放化疗联合TME手术安全可行,可提高局部进展期中低位直肠癌的根治性切除率与保肛率,不增加手术并发症,是局部进展期中低位直肠癌的优选治疗模式。
Bibliography:42-1241/R
Objective To explore the value and feasibility of combined neoadjuvant radiochemotherapy with TME in the treatment of locally advanced mid-distal rectal cancer.Methods One hundred and eleven patients with locally advanced mid-distal rectal cancer（T3～4N0～2M0） underwent preoperative radiochemotherapy with a dose of 50 Gy.Chemotherapy regimens were oxaliplatin combined capecitabine（combination group） and the single agent alone without oxaliplatin（single drug group）.One hundred and five patients received radical（R0） TME operations within 2～10 weeks after radiochemotherapy and the efficacy of the radiochemotherapy could be evaluated according to the postoperative pathological results.Results Radical TME were carried out on 105 patients with clear margin.Sphincter-sparing surgery was performed in 42（37.8%） patients.Radical（R0） TME operations were performed in 15（83.3%） out of the 18 T4 patient,staged by the MRI and CT,after radiochemotherapy.There were no severe complications during the treatment of neoadj
ISSN:1000-8578