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目的探讨术前三维适型放疗联合化疗对中低位直肠癌微血管密度(MVD)及血管内皮生长因子(VEGF)的影响。方法63例腔内超声为T3、T4期中低位直肠癌患者,32例常规放射治疗至35～48Gy;31例常规放疗20Gy后再予三维适形放疗20Gy两组均在接受放疗同时接受FOLFOX4方案化疗2个疗程,放疗结束后4～6周复查腔内超声并手术,病理常规加MVD及VEGF表达检测。结果三维适型放疗组的腹泻、放射性膀胱炎等副作用减少,肿瘤降期作用明显,MVD及VEGF表达下调,平均38.7个月随访局部复发率较低。结论三维适形放疗联合化疗可提高术前放化疗的疗效,降低局部复发率和MVD表达。
Objective To investigate the effect of preoperative three-dimensional conformal radiotherapy combined with chemotherapy on microvascular density (MVD) and vascular endothelial growth factor (VEGF) in low and middle rectal cancer. Methods Totally 63 cases of low and middle rectal cancer patients in stage T3 and T4 were treated with radiotherapy and 32 patients received routine radiotherapy until 35 ~ 48 Gy. Twenty-one cases received 20 Fy of conventional radiotherapy and 20 Gy of conventional radiotherapy. Both groups were receiving radiotherapy while receiving FOLFOX4 regimen 2 courses of treatment, 4 to 6 weeks after the end of radiotherapy for intra-uterine ultrasound and surgery, routine pathological examination plus MVD and VEGF expression. Results Three-dimensional conformal radiotherapy group had fewer side effects such as diarrhea and radiation cystitis, obvious tumor expiration, and lower MVD and VEGF expression. The average local follow-up rate was 38.7 months. Conclusion Three-dimensional conformal radiotherapy combined with chemotherapy can improve the efficacy of preoperative radiotherapy and chemotherapy, reduce the local recurrence rate and MVD expression.