Objective To investigate the efficacy of preoperative concurrent radiotherapy and chemotherapy in middle and low rectal cancer.Methods From October 2012 to September 2016,64 patients with middle and low rectal cancer underwent surgical treatment,were randomly divided into two groups,the treatment group 32 cases,the application of simultaneous preoperative radiotherapy and chemotherapy and surgery,control group of 46 patients,only the application of surgical treatment.After treatment,the efficacy,tumor decline,adverse reactions,serum CEA levels,the lower edge of the tumor to the anal distance,the longest diameter of the tumor and quality of life improvement were compared between two groups,and compared the local recurrence and survival of 2 groups in 3 and 5 years.Results The total effective rate of the treatment group was 78.13％,the rate of tumor decline was 87.5％,the improvement rate of quality of life 84.38％,the survival rate of 3 years and 5 years were 90.63％and 75％(19.14±8.52)ng/mL,the distance from the lower edge of the tumor to the anal margin was(7.88±2.07)cm,and the longest diameter of the tumor was(2.24±1.15)cm(P<0.05).The local recurrence rates were 6.25％and 15.63％in 3 years and 5 years,which were all lower than those in the control group(P<0.05).The side effects after radiotherapy and chemotherapy in the treatment group were(31.8％),nausea and vomiting(46.88％),radioactive pancreatitis(71.88％),neurotoxicity(3.13％),liver function abnormality(31.25％),leukopenia(25.00％),hemoglobin reduction),Diarrhea(87.5％),the vast majority of Ⅰ～Ⅱ degrees,the corresponding treatment were relieved.Conclusion The clinical curative effect of preoperative concurrent chemoradiation and radiotherapy of middle and low rectal cancer is significant,which has clinical value.%目的 临床疗效.方法 将2012年10月～2016年9月在浙江省嘉兴市第一医院接受手术治疗的64例中低位直肠癌患者,随机分为2组,治疗组32例,应用术前同步放化疗和手术治疗;对照组32例,仅应用手术治疗.治疗后,比较2组疗效、肿瘤降期情况、不良反应、血清CEA水平、肿块下缘至肛缘距离、肿块最长径等指标以及生活质量改善情况,并比较2组3、5年的局部复发情况和存活情况.结果 治疗组的总有效率为78.13％,肿瘤降期率为87.5％,生活质量改善率84.38％,3、5年的存活率分别为90.63％、75％,均高于对照组,差异均具统计学意义( P <0.05);治疗组的血清CEA水平(19.14±8.52)ng/mL,肿块下缘至肛缘距离(7.88±2.07)cm,肿块最长径(2.24±1.15)cm,3、5年的局部复发率分别为6.25％、15.63％,均低于对照组,差异均具统计学意义( P <0.05);治疗组放化疗后出现的不良反应为神经毒性(3.13％)、肝功能异常(31.25％)、白细胞减少(25.00％)、血红蛋白减少(31.25％)、皮肤黏膜反应(46.88％)、恶心呕吐(46.88％)、放射性胰腺炎(71.88％)、腹泻(87.5％)等,绝大多数为Ⅰ～Ⅱ度,经相应处理后均缓解.结论 中低位直肠癌术前同步放化疗的临床疗效显著.
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