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目的:评价术前三维适形放疗并卡培他滨治疗局部晚期直肠癌的耐受性和有效性。方法:45例初诊局部晚期直肠癌患者入组,治疗前经病理确诊:直肠腺癌。所有患者予三维适形放疗:DT50Gy/25次。化疗在放疗的第l天开始给药,卡培他滨825 mg/m2.次,2次/d,与放疗同步(每周5天)。手术在放化疗结束5、6周后进行。结果:完成术前计划并进行手术者43例。手术标本总有效率56.3%,肿瘤全消6例,仅见少量肿瘤残留16例。全组无4级毒副反应发生,3级毒副反应包括:放射性皮炎l例,腹泻2例,放射性肠炎1例。结论:术前三维适形放疗并卡培他滨治疗局部晚期直肠癌明显降低肿瘤分期、提高手术保肛率,且不良反应少,大多数患者可耐受。
OBJECTIVE: To evaluate the tolerability and efficacy of preoperative three-dimensional conformal radiotherapy and capecitabine in the treatment of locally advanced rectal cancer. Methods: 45 cases of newly diagnosed locally advanced rectal cancer patients were enrolled and pathologically confirmed before treatment: rectal adenocarcinoma. All patients to three-dimensional conformal radiotherapy: DT50Gy / 25 times. Chemotherapy began on day l of radiotherapy, with capecitabine 825 mg / m2, twice daily, and concurrently with radiotherapy (5 days a week). Surgery was performed 5 to 6 weeks after the end of radiotherapy and chemotherapy. Results: Complete preoperative planning and surgery in 43 cases. The total effective rate of surgical specimens 56.3%, 6 cases of complete elimination of the tumor, only a small amount of tumor remained in 16 cases. The whole group no grade 4 toxicity, grade 3 toxicity include: 1 cases of radiodermatitis, 2 cases of diarrhea, 1 case of radiation enteritis. Conclusions: Preoperative three-dimensional conformal radiotherapy combined with capecitabine in the treatment of locally advanced rectal cancer significantly reduces the tumor stage, improves the rate of the anal sphincter preservation, and has fewer adverse reactions. Most patients are tolerant.