摘要
目的 :探讨手术合并术中放疗对直肠癌的疗效。方法 :97例直肠癌患者在手术切除病灶后 ,用 9～16MeV电子线照射瘤床及周围淋巴引流区 ,照射剂量在 10～ 3 0Gy之间。并与单纯手术组 12 2例进行同期对照。结果 :DukesA期直肠癌手术加术中放疗对五年局部复发率和生存率无影响 ,DukesB期较单纯手术组三年、五年局部复发率分别下降 19%、2 0 .2 % ,三年、五年生存率分别提高 19.9%、2 7.2 % (P <0 .0 1) ;DukesC期较单纯手术组三年、五年局部复发率分别下降 2 8.8%、2 6.7% ,三年、五年生存率则分别提高 2 2 .2 %、3 2 .9% (P <0 .0 5) ;DukesD期患者较单纯手术组五年局部复发率虽下降 2 6.0 % ,但无统计学意义 ,五年生存率未见提高。术中放疗有可能增加粘连性肠梗阻的发生 ,无其他严重并发症。结论 :手术结合术中放疗能提高DukesB期、C期直肠癌的三年。
Purpose:To assess the effect of surgery combined with intraoperative radiotherapy (IORT) in the treatment of rectal carcinoma.Methods:97 patients with rectal carcinoma underwent IORT with 10～30Gy by 9～16MeV elect ro n beam to the tumor bed and local lymphatic regions. Another 122 patients treate d by surgery alone served as control.Results:Surgery combined w ith IORT did not improve the 5-year survival rate and local recurrence rate in the stage Dukes A patients. IORT have increased the 3-year and the 5-year surv ival rates in the stage Dukes B patients to 19.9%?27.2%, decreased their local recurrence rates to 19%?20.2%(P<0.01), increased the 3-year and the 5-yea r survival rates in the stage Dukes C patients to 22.2%?32.9%, decreased their local recurrence rates to 28.8%?26.7% (P<0.05);in the stage Dukes D patien ts, 5-year local recurrence rate decreased 26.0%, but there was no statistical difference, its 5-year survival rate did not increase. No serious complication s except adhesive intestinal obstruction were observed in IORT group.Conclusions:surgery combined with IORT can improve the 3-year ?the 5-year survival and reduce the local recurrence in the stage Dukes B and C patients.
出处
《中国癌症杂志》
CAS
CSCD
2004年第1期61-64,共4页
China Oncology
关键词
直肠癌
术中放疗
手术治疗
综合治疗
rectal carcinoma
intraoperative radiotherapy
surgery therapy
combined treatment
