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目的探讨高强度聚焦超声(HIFU)联合同步放化疗治疗复发性直肠癌的疗效及不良反应。方法 48例复发性直肠癌患者,随机分为实验组(20例)和对照组(28例)。实验组给予HIFU+同步放化疗,对照组单纯同步放化疗,两组放化疗方案均相同。比较两组的治疗有效率、镜下切缘无癌残留(R0)手术切除率、病理缓解率及1、2、3年生存率和不良反应情况。结果实验组患者的总有效率90.0%、R0手术切除率80.0%明显优于对照组的64.3%、50.0%,差异具有统计学意义(P<0.05)。所有患者均随访至2017年3月,实验组远处转移4例,对照组远处转移7例,主要为肺肝转移。两组患者的不良反应比较差异无统计学意义(P>0.05)。两组患者1、2、3年生存率比较差异均具有统计学意义(P<0.05)。结论高强度聚焦超声联合同步放化疗治疗复发性直肠癌可以提高R0手术切除率,长期生存率,且不良反应无明显增加。
Objective To investigate the efficacy and adverse reactions of high intensity focused ultrasound (HIFU) combined with concurrent chemoradiotherapy in the treatment of recurrent rectal cancer. Methods Forty-eight patients with recurrent rectal cancer were randomly divided into experimental group (n = 20) and control group (n = 28). The experimental group was treated with HIFU + concurrent chemoradiotherapy and the control group with concurrent chemoradiotherapy. The two chemoradiation regimens were the same. The therapeutic efficiency was compared between the two groups. Surgical resection rate, pathological remission rate, 1, 2, 3-year survival rate and adverse reactions without residual cancer (R0) were observed. Results The total effective rate was 90.0% in the experimental group and 80.0% in the R0 group was significantly better than that in the control group (64.3%, 50.0%). The difference was statistically significant (P <0.05). All patients were followed up until March 2017, 4 cases of distant metastasis in the experimental group, and 7 cases of distant metastasis in the control group, mainly lung and liver metastasis. There was no significant difference in adverse reactions between the two groups (P> 0.05). The difference of 1, 2, 3 year survival rates between the two groups was statistically significant (P <0.05). Conclusion High-intensity focused ultrasound combined with concurrent chemoradiotherapy in the treatment of recurrent rectal cancer can improve the R0 resection rate and long-term survival rate, and no significant increase in adverse reactions.