| 潘宏达,王 林,詹天成.中低位局部进展期直肠癌术前30Gy/10f短程放疗初步探讨[J].肿瘤学杂志,2015,21(1):14-20. |
| 中低位局部进展期直肠癌术前30Gy/10f短程放疗初步探讨 |
| Preliminary Investigation of preoperative 30Gy/10f Short Course Radiotherapy for Middle-lower Locally Advanced Rectal Cancer |
| 投稿时间：2014-09-10 |
| DOI：10.11735/j.issn.1671-170X.2015.01.B004 |
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| 中文关键词: 直肠肿瘤 术前放疗 短程放疗 预后 |
| 英文关键词:rectal neoplasms preoperative radiotherapy short course radiotherapy prognosis |
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| 中文摘要: |
| 摘 要：［目的］探讨中低位局部进展期直肠癌术前30Gy/10f短程放疗的治疗效果及预后因素分析。［方法］ 中低位局部进展期直肠癌患者282例。总剂量30Gy，分10次照射的术前短程放疗方案（30Gy/10f），生物有效剂量为36Gy，照射方式为3D适形放疗。放疗后休息2~4周后行手术治疗。分析相关临床病理学因素对预后的影响。［结果］ 病理完全缓解率（ypCR）为5.7%（16/282），术后病理降期率35.8%（101/282）。3年无病生存率为78.0%，局部复发率4.6%(13/282)。发生转移50例，无转移生存率82.3%。同时合并转移、复发1例。多因素分析表明：肿瘤分化程度、ypN分期、手术方式是影响3年无病生存率的独立因素。环周切缘状态和ypN分期是影响局部复发的独立因素。［结论］中低位局部进展期直肠癌术前应用30Gy/10f短程放疗可以获得良好的局部控制，是一种有效的新辅助治疗方案。 |
| 英文摘要: |
| Abstract：［Purpose］ To investigate the treatment effect and prognostic factors of preoperative 30Gy/10f short course radiotherapy for middle-lower locally advanced rectal cancer .［Methods］Two hundred and eight-two patients with middle-lower locally advanced rectal cancer were studied. All the patients underwent preoperative radiotherapy with scheme recommended by Chinese Anti-Cancer Association. Total dose of 30Gy was divided into 10 fragments(30Gy/10f)，the biologically effective dose(BED) was 36Gy，3D conformal radiotherapy(3D-CRT) was used. The curative surgery was performed 2～4 weeks after the preoperative radiotherapy. The prognostic effect of clinicopathological factors were analyzed retrospectively. ［Results］ The yield pathological complete response(ypCR) was 5.7%(16/282)，postoperative downstaging rate was 35.8%(101/282). 3-year disease-free survival(DFS) was 78.0%，local recurrence rate was 4.6%(13/282)，metastasis was found in 50 patients，3-year metastasis-free survival was 82.3%. One patient developed synchronous local recurrence and metastasis. Multivariate analysis showed that differentiation，ypN stage，surgical type were the independent prognostic factors of 3-year DFS，and circumferential resection margin(CRM) state and ypN stage were the independent prognostic factors of local recurrence.［Conclusion］ Middle-lower locally advanced rectal cancer with preoperative 30Gy/10f short course radiotherapy might achieve satisfying treatment effect. Therefore，30Gy/10f short course radiotherapy is reliable and effective. |
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