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Comparison of long-term efficacy between preoperative radiotherapy or radiochemotherapy followed by lower-aterior resection and Miles abdominoperineal resection in patients with low rectal cancer
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- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF GASTROINTESTINAL SURGERY
- Issue:
- 4
- DOI:
- 10.3760/cma.j.issn.1671-0274.2005.04.007
- Key Word:
- 直肠肿瘤;放射治疗 ,术前;化学治疗,术前;手术;预后
Abstract： 目的分析局部进展期低位直肠癌术前放化疗加前切除术或术前放疗加前切除术与 Miles手术的远期效果.方法 157例低位直肠癌患者为 1983年1月至 2000年12月收治,原发肿瘤距肛门中位距离 6.1 cm,临床分期Ⅱ期 69例,Ⅲ期 88例(TNM,UICC).放疗方法为术前直线加速器的盆腔四野照射,35～45 Gy/4～5周;化疗方法为以氟尿嘧啶为主的联合化疗.予以术前放、化疗加前切除术 52例(A组);术前单纯放疗加前切除术 51例(B组);单纯 Miles手术 54例(C组).对全部患者的临床资料和随访结果进行回顾性分析.结果本组随访率 91.7%.5年生存率 A组 71.1%,B组 47.1%,C组 42.6%;A组明显高于 B和 C组(P< 0.05).无瘤生存率 A组 61.5%,B组 37.3%,C组 35.2%;A组仍明显高于 B和 C组(P< 0.05).局部复发率 A组 13.5%,B组 15.7%,C组 11.1%;3组之间差异无统计学意义(P>0.05).远处转移率(包括局部复发加远处转移)A组 23.1%,B组 49.0%,C组 46.3%;A组明显低于 B和 C组(P< 0.05).但 B组与 C组的差异无统计学意义(P>0.05).结论术前放、化疗加前切除手术治疗低位直肠癌的方法可改善 5年生存率和无瘤生存率,降低远处转移率.
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