论文部分内容阅读
本文回顾1972～1983年20例未能切除或局部晚期直肠癌病人施行术前放疗,以提高其切除率。明确肿瘤不能切除者,放疗主要用以缓解病情。未能明确肿瘤切除者,放疗的目的是争取进一步切除。18例在术前确定,仅2例在剖腹时确定。共计男15例,女5例,确诊时平均年龄为61岁(31～86岁),放疗总剂量平均为4600cGy(3100～5000CGy),每日分次剂量为180～200cGy,照射野约为15×15cm。多数病人耐受放疗良好,除1例外,全部病人在6周内完成治疗。此例在接受3800cGy后,因肠穿孔行急诊手术。其余病人在停止放疗后28天进行手术。19例行经腹会阴切除,1例行低位前切除,所有病人随访至少5年。结果放疗后13例最终行根治切除,其中5例原确定为不能切除术。主观判断与进一步的切除率明显相关(P<0.05)。
This article reviews 20 patients with unresectable or locally advanced rectal cancer who underwent preoperative radiotherapy from 1972 to 1983 to increase their resection rate. It is clear that tumors cannot be removed and radiotherapy is mainly used to relieve the disease. In the absence of clear tumor resection, the aim of radiotherapy is to seek further resection. 18 cases were confirmed before surgery, and only 2 cases were determined during caesarean section. A total of 15 males and 5 females were included. The average age at diagnosis was 61 years (31 to 86 years). The total dose of radiotherapy was 4600 cGy (3100 to 5000 CGy) on average, and the daily divided dose was 180 to 200 cGy. The radiation field was about 15 ×15cm. Most patients tolerated radiation therapy well, with one exception, all patients completed treatment within 6 weeks. In this case, after receiving 3800cGy, an emergency operation was performed for intestinal perforation. The remaining patients were operated 28 days after stopping radiotherapy. 19 cases underwent transabdominal perineal resection and 1 underwent low resection. All patients were followed for at least 5 years. Results Radical resection was performed in 13 cases after radiotherapy, and 5 of them were originally determined to be unresectable. Subjective judgment was significantly correlated with further resection rate (P<0.05).