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目的探讨术前口服卡培他滨与放疗联合治疗对低位直肠癌的疗效。方法 44例低位直肠癌患者均给予术前新辅助放化疗,口服卡培他滨1650 mg/(m2.d),分2次服用,共服2个疗程,化疗同时开始体外放疗,2 Gy/d,每周治疗5 d,总剂量为50 Gy。分析术前新辅助放化疗与预后的关系。结果全部病例按计划完成新辅助放化疗。84.1%的患者肿瘤分期降级,癌灶范围缩小,距肛缘的距离增大,所有患者均施行根治性切除术,保肛率达100%,83.5%的患者肛门括约肌功能良好。随访发现患者术后2年生存率为83.6%(39/44);仍然健在的患者的术后生存期为26～52个月,平均41.2个月。结论低位直肠癌采用术前新辅助放化疗确实能达到肿瘤降期、局部复发率降低、提高手术切除率、生存率和保肛成功率等目的,是治疗对低位直肠癌的一种有效辅助措施。
Objective To investigate the effect of preoperative capecitabine combined with radiotherapy on low rectal cancer. Methods Forty - four patients with low rectal cancer were treated with neoadjuvant chemoradiation and received capecitabine 1650 mg / (m2.d) orally for 2 times in a total of 2 courses. Chemotherapy combined with 2 Gy / d, weekly treatment of 5 d, the total dose of 50 Gy. Preoperative neoadjuvant chemoradiation and prognosis were analyzed. Results All cases completed neoadjuvant chemoradiation as planned. In 84.1% of the patients, the staging of the tumor was degraded, the scope of the lesion was narrowed and the distance from the anal verge increased. All the patients underwent radical resection and the rate of anus retention was 100%. Anal sphincter function was good in 83.5% of the patients. Follow-up found that patients 2-year survival rate was 83.6% (39/44); still alive in patients with postoperative survival of 26 to 52 months, an average of 41.2 months. Conclusions The preoperative neoadjuvant chemoradiotherapy of low rectal cancer can indeed achieve the goal of tumor reduction, local recurrence rate reduction, and improve the resection rate, survival rate and the success rate of anal sphincter preservation. It is an effective adjuvant therapy for low rectal cancer .