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目的探讨术前放化疗对局部晚期中低位直肠癌疗效和预后的影响。方法对81例保肛术前行术前放化疗及113例接受Miles手术后常规化疗的局部晚期中低位直肠癌患者的临床资料进行回顾性分析。结果术前放化疗术后总的病理完全缓解率为13.6%,降期率达61.7%,保肛率达77.8%。术前放化疗组和Miles手术组的局部复发率分别为9.9%和20.4%(P<0.05),5年生存率分别为69.1%和61.1%(P>0.05)。结论术前放化疗有利于提高局部晚期中低位直肠癌的保肛率,采用保肛术的局部复发率较Miles手术低,生存率和Mi-les手术相近。
Objective To investigate the effect of preoperative chemoradiotherapy on the efficacy and prognosis of locally advanced low or middle rectal cancer. Methods A retrospective analysis was performed on the clinical data of 81 patients with preoperative anal preservation before radiotherapy and chemotherapy and 113 patients with locally advanced low or intermediate rectal cancer after conventional chemotherapy after Miles surgery. Results The total pathological complete remission rate was 13.6% after radiotherapy and chemotherapy, the rate of down-period was 61.7% and the rate of anal sphincter preservation reached 77.8%. The local recurrence rates of preoperative chemoradiation group and Miles operation group were 9.9% and 20.4%, respectively (P <0.05). The 5-year survival rates were 69.1% and 61.1% respectively (P> 0.05). Conclusions Preoperative chemoradiotherapy is helpful to improve the rate of anal sphincter in locally advanced low or middle rectal cancer. The local recurrence rate of anal sphincter preservation is lower than that of Miles operation, and the survival rate and Mi-les surgery are similar.