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[目的]探讨低位直肠癌术前放化疗加TME原则保肛术疗效。[方法]45例低位直肠癌患者,Ⅱ期26例,Ⅲ期19例。放疗采用三维适形放疗技术,放疗剂量为45Gy/4周,化疗采用FOLFOX方案,化疗在放疗开始第一、四周开始,放疗结束后4～5周行TME原则下保肛术。[结果]放化疗完成后10例达CR,28例PR,肿瘤有效率为84.4%。发生Ⅰ～Ⅱ度不良反应25例,5例出现Ⅲ度腹泻,3例出现Ⅲ度骨髓抑制。围手术期并发症发生率为15.6%,远期并发症发生率为13.3%。3年生存率为82.2%,5年生存率为75.6%。[结论]低位直肠癌患者术前进行放化疗有明显降期作用,可减轻放疗后围手术期并发症及远期并发症。
[Objective] To investigate the effect of preoperative chemoradiation and TME preserving anus in low rectal cancer. [Method] 45 patients with low rectal cancer, 26 cases of stage Ⅱ, 19 cases of stage Ⅲ. Radiotherapy using three-dimensional conformal radiotherapy technology, radiation dose 45Gy / 4 weeks, chemotherapy with FOLFOX program, chemotherapy in the first four weeks of radiotherapy began, 4 to 5 weeks after the end of radiotherapy TME under the principle of anal surgery. [Results] After radiotherapy and chemotherapy were completed, 10 patients achieved CR and 28 patients achieved PR. The tumor effective rate was 84.4%. There were 25 cases of grade Ⅰ ~ Ⅱ adverse reactions, 5 cases of grade Ⅲ diarrhea and 3 cases of grade Ⅲ myelosuppression. The incidence of perioperative complications was 15.6% and the incidence of long-term complications was 13.3%. 3-year survival rate was 82.2%, 5-year survival rate was 75.6%. [Conclusion] The preoperative radiotherapy and chemotherapy in patients with low rectal cancer have a significant effect of lowering the dosage, which can reduce the perioperative complications and long-term complications after radiotherapy.