目的:探讨术前不同放疗模式对局部晚期低位直肠癌的治疗意义.方法:40例局部晚期低位直肠癌患者,其中23例采用术前同步放化疗,放疗方式采用盆腔外照射,DT 50戈瑞/25次,化疗方案为卡培他滨750毫克/米2,每日两次口服,间隔12小时,连用5周,照射结束后4周手术.另17例患者采用短程低分割放疗方案,DT 25戈瑞/5次/5天,照射结束后1周左右手术.结果:术前同步放化疗组和术前短程低分割组有效率分别为78.2%和58.8%,保肛率分别为73.9%和44.4%,病理完全消失率分别为13.0%和0,3年生存率分别为73.9%和58.8%,P＜0.05,均有统计学差异.术后吻合口瘘发生率分别为4.3%和4.1%,P＞0.05 无统计学差异.结论:局部晚期低位直肠癌术前同步放化疗临床疗效好,生存质量高,为优先选择方案.%Objective:To observe the effect of different preoperative radiotherapy for locally advanced rectal cancer.Methods: Of 40 cases, 23 were treated with concurrent radiochemotherapy, using pelvic irradiation, DT 50Gy/25 times, chemotherapy: capecitabine 750mg/m2 , twice a day orally, interval of 12 hours, last 5 weeks, after 4 weeks operation was performed.Other 17 patients were treated with radiotherapy of short - range low segmentation schemes,DT 25 Gy/5 times/5 days, after 1 week operation was performed.Results: Preoperative concurrent radiochemotherapy group and separate groups of preoperative short - range efficiency rates were 78.2％ and 58.8％ , sphincter preservation rates were 73.9％ and 44.4％ , pathological disappearance rates were 13.0％ and 0,3 - year survival rates were 73.9％ and 58.8％ ,P ＜0.05.The incidence of postoperative anastomotic leakage was 4.3％ and 4.1％ ,P ＞0.05.Congclusion: The clinical effect of preoperative concurrent radiochemotherapy for locally advanced low rectal cancer was good with high quality of life and a priority option.
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