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直肠癌是最常见的恶性肿瘤之一。近年来,直肠癌在我国的发病率有上升的趋势。为提高手术治疗的近期和远期效果,术前同步放化疗已经成为局部进展期直肠癌的标准治疗方案[1-4]。由于正常组织耐受剂量的限制,许多患者出现了较为严重的急性和/或长期毒副作用,其中小肠是主要的剂量限制性器官。小肠对辐射高度敏感,当小肠受到辐射损伤时,可引起急性和晚期损伤,急性损伤主要表现为持续腹泻,晚期损伤则主要表现为小肠梗阻、溃疡、肠瘘、肠穿孔以及肠出血[5-6]。因此,直肠癌术前放疗中,正确勾画和评价至关重要。
Rectal cancer is one of the most common malignancies. In recent years, the incidence of rectal cancer in our country is on the rise. To improve the short-term and long-term effects of surgical treatment, preoperative concurrent chemoradiation has become the standard treatment for locally advanced rectal cancer [1-4]. Due to the limitations of normal tissue tolerance doses, many patients experience more severe acute and / or chronic side effects, with the small intestine being the predominant dose limiting organ. The small intestine is highly sensitive to radiation. When the small intestine is damaged by radiation, it can cause acute and late injury. The acute injury mainly manifests as persistent diarrhea, the late injury mainly as small bowel obstruction, ulcer, intestinal fistula, intestinal perforation and intestinal hemorrhage [5- 6]. Therefore, the preoperative radiotherapy for rectal cancer, correct delineation and evaluation is essential.