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目的探讨同步放化疗联合手术治疗中低位进展期直肠癌的近远期疗效。方法选取2013年12月至2015年12月新疆医科大学第五附属医院收治的50例中低位进展期直肠癌患者,按照就诊时间顺序分为对照组和观察组,每组25例。对照组仅给予全直肠系膜切除术治疗,观察组在此基础上加用同步放化疗治疗,比较两组患者住院时间、手术时间、治疗前后肿瘤标志物水平、切缘无癌细胞切除率、保肛率、随访1年的局部复发率和转移率。结果观察组患者切缘无癌细胞切除率和保肛率明显升高,与对照组比较,差异有统计学意义(P<0.05)。两组患者治疗后较治疗前比较,CEA、CA19-9、CA242水平均降低,观察组上述指标降低更加显著,与对照组比较,差异有统计学意义(P<0.05)。观察组患者随访1年局部复发率和远处转移率均较低,与对照组比较,差异有统计学意义(P<0.05)。结论同步放化疗联合手术治疗中低位进展期直肠癌的近期疗效显著,远期复发率和转移率较低,具有一定的临床意义。
Objective To investigate the short-term and long-term effects of concurrent chemoradiation and chemotherapy in the treatment of low-grade advanced rectal cancer. Methods From December 2013 to December 2015, 50 patients with advanced low grade rectal cancer admitted to the Fifth Affiliated Hospital of Xinjiang Medical University were divided into control group and observation group according to the order of treatment, with 25 cases in each group. The control group was given only mesorectal excision. The observation group was treated with concurrent radiotherapy and chemotherapy. The hospitalization time, operation time, tumor marker level before and after treatment, tumor resection rate at the margin were compared between the two groups Anal rate, follow-up of 1 year local recurrence rate and metastasis rate. Results There was no significant difference between the observation group and the control group (P <0.05). After treatment, the levels of CEA, CA19-9 and CA242 in both groups were lower than those before treatment, and the above indexes in the observation group decreased more significantly. Compared with the control group, the difference was statistically significant (P <0.05). The local recurrence rate and distant metastasis rate in the observation group at one year follow-up were all lower than those in the control group (P <0.05). Conclusions Simultaneous chemoradiotherapy combined with surgery for the treatment of low and advanced advanced rectal cancer has obvious curative effect in the short term and low recurrence rate and metastasis rate, which is of clinical significance.